The prognostic significance of sarcopenia in mantle cell lymphoma patients

Prognosis determination in diagnosis is important for predicting the ultimate outcome of cancer patients and selecting the appropriate treatment option. Among hematological cancers, the prognostic significance of sarcopenia, especially in Diffuse Large B-Cell Lymphoma (DLBCL), has become an intriguing research topic today. In this study, we aimed to investigate the impact of sarcopenia on prognosis in patients with Mantle Cell Lymphoma (MCL), a rarer subtype of NHL. Demographic data, genetic and pathology results, disease stages, laboratory data, pre- and post-treatment PET-CT images, administered chemotherapy regimens, and treatment responses were retrospectively evaluated for 44 patients diagnosed with MCL. Those identified as sarcopenic based on PET-CT images were identified, and their impact on prognosis was investigated. Parameters affecting progression-free survival and overall survival in patients were statistically analyzed. The PFS (Progression-Free Survival) duration was calculated as 29.41 months, and similarly, the OS (Overall Survival) duration was calculated as 46.42 months. In the single-variable analysis for PFS, variables such as ECOG score (p<0.001), Ann Arbor Stage (p=0.042), bone marrow infiltration (p=0.029), refractory disease (p=0.021), relapsed disease (p=0.011), and response after the first-line treatment (p<0.001) were found to have a significant relationship with PFS. However, in the single-variable analysis, no significant result was found for the relationship between sarcopenia and PFS (p=0.212). In the multivariable analysis, ECOG score (p=0.023), refractory disease (p=0.004), relapsed disease (p=0.007), and response after the first-line treatment (p=0.005) remained significant for PFS, while the significance of Ann Arbor Stage and bone marrow infiltration was lost. For OS (Overall Survival), in the single-variable analysis, ECOG score (p<0.001) and LDH level (p=0.024) were found to be significant. However, in the multivariable analysis, ECOG score (p=0.002) retained its significance, while LDH level (p>0.05) lost its significance. As with PFS, the single-variable analysis for OS also found no significant relationship between sarcopenia and OS (p=0.208). In the literature, there is only one study related to this topic, which found that total survival is not affected in sarcopenic patients, while progression-free survival is lower. However, in our study, we did not find a significant relationship between sarcopenia and survival in MCL patients.