Impact of Cachexia on Clinical Outcomes in Aggressive Lymphomas

Aim 1: We will evaluate the impact of cachexia measured longitudinally on clinical outcomes in aggressive B-Cell non-Hodgkin Lymphoma (B-NHL) treated with standard chemo-immunotherapy. We hypothesize that cachexia, defined primarily by loss of muscle (sarcopenia) and loss of fat (adipopenia), will predict for poor progression-free and overall survival in aggressive B-NHL treated with standard frontline chemo-immunotherapy. To identify earliest signs of cachexia, computed tomography (CT) muscle and fat indices will be measured longitudinally from diagnosis through treatment course and disease relapse in 40 patients with Slice-O-Matic software using published methods. Aim 2: We will study associations between selected serum biomarkers, muscle and adipose index values, and survival in aggressive B-NHL treated with standard chemo-immunotherapy. We hypothesize that biomarkers implicated in processes underlying cancer cachexia, including inflammation, energy intake and expenditure, muscle function and integrity, appetite, and glucose utilization/IGF pathway, will be strongly associated with poor progression-free and overall survival in patients with aggressive lymphoma receiving frontline chemo-immunotherapy. The identical cohort from Aim 1 (n=40) will be used in this aim, with patient-matching sets of serum specimens from baseline, after 4 cycles of treatment, post completion of therapy, and at time of relapse evaluated.