Metabolic Biomarkers Assessed with PET/CT Predict Sex-Specific Longitudinal Outcomes in Patients with Diffuse Large B-Cell Lymphoma

Shama Jaswal, Vanessa Sanders, Priyanka Pullarkat, Stephanie Teja, Amber Salter, Marcus P. Watkins, Norman Atagu, Daniel R. Ludwig, Joyce Mhlanga, Vincent M. Mellnick, Linda R. Peterson, Nancy L. Bartlett, Brad S. Kahl, Todd A. Fehniger, Armin Ghobadi, Amanda F. Cashen, Neha Mehta-Shah, Joseph E. Ippolito

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

In many cancers, including lymphoma, males have higher incidence and mortality than females. Emerging evidence demonstrates that one mechanism underlying this phenomenon is sex differences in metabolism, both with respect to tumor nutrient consumption and systemic altera-tions in metabolism, i.e., obesity. We wanted to determine if visceral fat and tumor glucose uptake with fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) could predict sex-dependent outcomes in patients with diffuse large B-cell lymphoma (DLBCL). We conducted a retrospective analysis of 160 patients (84 males; 76 females) with DLBCL who had imaging at initial staging and after completion of therapy. CT-based relative visceral fat area (rVFA), PET-based SUVmax normalized to lean body mass (SULmax), and end-of-treatment FDG-PET 5PS score were calculated. Increased rVFA at initial staging was an independent predictor of poor OS only in females. At the end of therapy, increase in visceral fat was a significant predictor of poor survival only in females. Combining the change in rVFA and 5PS scores identified a subgroup of females with visceral fat gain and high 5PS with exceptionally poor outcomes. These data suggest that visceral fat and tumor FDG uptake can predict outcomes in DLBCL patients in a sex-specific fashion.

Original languageEnglish (US)
Article number2932
JournalCancers
Volume14
Issue number12
DOIs
StatePublished - Jun 1 2022
Externally publishedYes

Keywords

  • CT
  • DLBCL
  • FDG-PET
  • body composition
  • glucose metabolism
  • lymphoma
  • sex differences
  • visceral fat

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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