Impact of body composition on toxicity and response in patients with advanced-stage Hodgkin lymphoma treated with BV-AVD
4 affiliations
- 1Division of Hematology, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL
- 2Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL
- 3Department of Biostatistics, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL
- 4Division of Nuclear Medicine, Department of Radiology, University of Miami Miller School of Medicine, Miami, FL
Abstract
BV-AVD (brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine) has improved outcomes in advanced-stage Hodgkin lymphoma (ASHL); however, toxicity such as peripheral neuropathy (PN) remains a concern. Previous studies in oncology have demonstrated an association between sarcopenia and chemotoxicity. Therefore, we examined the effects of body composition parameters, including skeletal muscle (SM), subcutaneous fat (SF), and visceral fat (VF), along with quantitative biomarkers including metabolic tumor volume (MTV), on PN, treatment response, and progression-free survival. This study retrospectively reviewed the baseline, interim, and end-of-treatment (EOT) positron emission tomography-computed tomography (PET-CT) for 39 patients with ASHL treated with BV-AVD and assessed changes in MTV and body composition. MTV declined significantly from baseline to interim PET and EOT PET-CT (EOT PET), with no significant difference between the latter time points, indicating an early treatment response. SM:VF and SF:VF ratios followed a similar pattern, suggesting that changes in body composition including SM loss (sarcopenia) and changes in fat distribution (SF:VF), occurred early during treatment. Patients with stable SM:VF ratios were more likely to achieve a complete response (CR), whereas larger changes in SM:VF and SF:VF ratios and an early increase in VF were associated with failure to achieve CR, possibly due to increased inflammation. Stage IV disease and higher MTV were both associated with increased PN and may reflect the wider distribution of BV and an amplified inflammatory response. These findings demonstrate that body composition and PET-CT indices are relevant biomarkers in ASHL, and their integration with MTV may enhance risk stratification and deepen our understanding of toxicity risk.
Related
- The relationship of homocysteine and its redox forms with renal toxicity after high-dose methotrexate treatment in patients with leukemia or lymphoma
- Correlation between circulating tumor cell levels and tumor response in patients with advanced hepatocellular carcinoma undergoing immunotherapy and molecular targeted therapy
- Quantitative Molecular Breast Imaging for Early Prediction of Neoadjuvant Systemic Therapy Response in Locally Advanced Breast Cancer Patients
- Pretreatment Body Composition and Its Association with Pathologic Complete Response and Survival in Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy: A Retrospective Cohort Study
- Pretreatment Prognostic Nutritional Index Is Associated with Treatment Response and Survival in Patients with Relapsed or Refractory Non-Hodgkin Lymphoma Receiving CAR-T Cell Therapy
BibTeX
@article{stanchina2026impact,
title = {{Impact of body composition on toxicity and response in patients with advanced-stage Hodgkin lymphoma treated with BV-AVD}},
author = {Michele D. Stanchina and Russ A. Kuker and Sunwoo Han and Craig H. Moskowitz and Mark K. Polar and Fei Yang and Tracy E. Crane and Melissa L. Lopez and Juan Pablo Alderuccio},
journal = {Blood neoplasia},
year = {2026},
month = sep,
doi = {10.1016/j.bneo.2026.100303},
url = {https://europepmc.org/article/PMC/PMC13717734},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Impact of body composition on toxicity and response in patients with advanced-stage Hodgkin lymphoma treated with BV-AVD
AU - Michele D. Stanchina
AU - Russ A. Kuker
AU - Sunwoo Han
AU - Craig H. Moskowitz
AU - Mark K. Polar
AU - Fei Yang
AU - Tracy E. Crane
AU - Melissa L. Lopez
AU - Juan Pablo Alderuccio
PY - 2026
DA - 2026/09/08
JO - Blood neoplasia
DO - 10.1016/j.bneo.2026.100303
UR - https://europepmc.org/article/PMC/PMC13717734
AB - BV-AVD (brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine) has improved outcomes in advanced-stage Hodgkin lymphoma (ASHL); however, toxicity such as peripheral neuropathy (PN) remains a concern. Previous studies in oncology have demonstrated an association between sarcopenia and chemotoxicity. Therefore, we examined the effects of body composition parameters, including skeletal muscle (SM), subcutaneous fat (SF), and visceral fat (VF), along with quantitative biomarkers including metabolic tumor volume (MTV), on PN, treatment response, and progression-free survival. This study retrospectively reviewed the baseline, interim, and end-of-treatment (EOT) positron emission tomography-computed tomography (PET-CT) for 39 patients with ASHL treated with BV-AVD and assessed changes in MTV and body composition. MTV declined significantly from baseline to interim PET and EOT PET-CT (EOT PET), with no significant difference between the latter time points, indicating an early treatment response. SM:VF and SF:VF ratios followed a similar pattern, suggesting that changes in body composition including SM loss (sarcopenia) and changes in fat distribution (SF:VF), occurred early during treatment. Patients with stable SM:VF ratios were more likely to achieve a complete response (CR), whereas larger changes in SM:VF and SF:VF ratios and an early increase in VF were associated with failure to achieve CR, possibly due to increased inflammation. Stage IV disease and higher MTV were both associated with increased PN and may reflect the wider distribution of BV and an amplified inflammatory response. These findings demonstrate that body composition and PET-CT indices are relevant biomarkers in ASHL, and their integration with MTV may enhance risk stratification and deepen our understanding of toxicity risk.
SN - 2950-3280
ER -