Comparative analysis of volume and distribution of body fat in patients with lymphoma before and after chemotherapy

Obesity and chemotherapy with anthracyclines are risk factors for the development of cardiovascular diseases. Additionally, the higher the deposition of visceral fat (VF) and epicardial fat (EpF) in relation to subcutaneous fat (SF), the worse the cardiac risk. In lymphoma patients, whole-body positron emission tomography (PET) combined with computed tomography (CT) should be routinely performed before, during, and after the completion of cancer treatment for prognostic and therapeutic evaluation. However, whole-body PET/CT can also be useful in monitoring metabolic changes occurring in these patients due to cancer and chemotherapy, particularly those related to body fat.

To evaluate the effects of chemotherapy on the distribution and volume of body fat using PET/CT.

A blind, comparative, observational, and analytical study. The measurement of SF, VF, and EpF volumes and attenuation densities was performed on PET/CT scans of 20 lymphoma patients before and after anthracycline chemotherapy using the LifeX software by two independent researchers who were blind to the phase of cancer treatment. A p-value < 0.05 was considered statistically significant.

The mean age of the patients was 42.5 ± 17 y/o, 12 out of 20 (60%) being female and a median body weight of 60.5 kg before and 63.5 kg after chemotherapy (p=0.21). After chemotherapy, there was an increase in SF (from 1635.5mL to 2304.0mL, 41% increase, p=0.0037), VF (from 768.5mL to 1431.0mL; 86% increase, p=0.0094), and EpF (from 60.9mL to 99.4mL; 63% increase, p<0.0001), compared to the pre-chemotherapy phase. Regarding the intensity of attenuation of SF, VF, and EpF densities, no significant changes were observed before and after chemotherapy.

In lymphoma patients after completing chemotherapy cycles, there was a significant increase in body fat and a change in its distribution pattern, with a relatively greater growth in the volume of VF, followed by EpF. These results could reflect the worsening of the cardiometabolic profile and cardiovascular risk in these patients in the post- chemotherapy context.