Young patients with lymphoma or rhabdomyosarcoma may experience changes in body composition during chemotherapy, according to a study published in Cancer. 

Researchers found that patients had a significant decline in skeletal muscle density during chemotherapy, and this was associated with a higher risk of chemotoxicity.

For this study, researchers assessed changes in body composition among children, adolescents, and young adults diagnosed with lymphoma or rhabdomyosarcoma between 2000 and 2015 at a single center.

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The 78 patients studied had a median age at diagnosis of 12.7 (range, 2.5-21.1) years. More than half of the patients were non-Hispanic White (55.1%) and male (62.8%). Patients had Hodgkin lymphoma (41.0%), non-Hodgkin lymphoma (38.5%), or rhabdomyosarcoma (20.5%).

The patients had a staging computed tomography (CT) scan prior to chemotherapy initiation and another CT scan upon first follow-up. A total of 436 chemotherapy cycles were recorded between scans 1 and 2, with a median of 5 cycles per patient (range, 1-9).

The researchers found that skeletal muscle density declined significantly between scans 1 and 2 (β∆SMD ± standard error [SE] = −4.1 ± 1.4; P =.004).

However, there was no significant difference between the scans in terms of body surface area (β∆BSA ± SE = −0.02 ± 0.01; P =.3), body mass index percentile (β∆BMIpercentile ± SE = 4.1 ± 4.8; P =.3), height-adjusted total adipose tissue (β∆hTAT ± SE = 5.5 ± 3.9; P =.2), or skeletal muscle index (β∆SMI ± SE = −0.5 ± 1.0; P =.7). 

When the researchers looked at toxicities, they found grade 4 hematologic toxicities in 33.3% of the chemotherapy cycles and grade 3 or higher nonhematologic toxicities in 23.6% of cycles.

The researchers also found that a decline in skeletal muscle density was associated with a higher risk of grade 3 or higher nonhematologic toxicities after adjusting for demographic and clinical variables (βper unit SMD decline ± SE = 1.09 ± 0.51; P =.04).

“In conclusion, we show that significant changes in body composition occur in children, adolescents, and young adults with lymphoma and rhabdomyosarcoma, despite no observed significant change in routinely available anthropometric measurements,” the researchers wrote. “We also show that decline in SMD [skeletal muscle density] is associated with the risk of chemotoxicity.” 


Wadhwa A, Lim S, Dai C, et al. Assessment of longitudinal changes in body composition of children with lymphoma and rhabdomyosarcoma. Cancer. Published online July 11, 2023. doi:10.1002/cncr.34936

This article originally appeared on Cancer Therapy Advisor