Early adipose tissue gain associated with relapse in PET-negative pediatric Hodgkin lymphoma

An observational analysis published in JNCI examined whether early changes in body composition were associated with relapse in children with intermediate- or high-risk Hodgkin lymphoma. Researchers assessed CT-measured skeletal muscle area and total adipose tissue area before treatment and after two chemotherapy cycles in 951 children enrolled in Children’s Oncology Group trials AHOD0031 and AHOD0831. Median age at diagnosis was 15.2 years. Relapse analyses accounted for non-relapse death as a competing risk and adjusted for prognostic factors, including baseline body composition.

Excessive adipose tissue gain, defined as an increase exceeding the median increase, occurred in 36.2% of participants. Among children with negative PET findings after cycle two (PET2), it was associated with a higher adjusted hazard of relapse (hazard ratio 1.73; 95% CI 1.08–2.77; P=0.02). No association was detected in the PET2-positive group (hazard ratio 0.90; 95% CI 0.51–1.57; P=0.70). Excessive changes in skeletal muscle area were not associated with relapse.

The findings identify early adipose tissue gain as a candidate prognostic biomarker in PET2-negative disease, rather than an established treatment target. This observational association does not establish causality or show that preventing adipose gain reduces relapse. Only the abstract was available; absolute relapse risks and follow-up duration were not provided.