{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T23:38:14Z","timestamp":1789256294194,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T00:00:00Z","timestamp":1623369600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Elderly classical Hodgkin lymphoma (cHL) (ecHL) is a rare disease with dismal prognosis and no standard treatment. Fitness\u2010based approaches may help design appropriate treatments. Sarcopenia has been associated with an increased risk of treatment\u2010related toxicities and worse survival in various solid tumours, but its impact in ecHL is unknown. The aim of this retrospective multicentre study was to investigate the prognostic role of sarcopenia in ecHL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included newly diagnosed &gt;64\u00a0years old cHL patients who performed a baseline comprehensive geriatric assessment and high\u2010dose computed tomography (CT) or 18fluorine\u2010fluorodeoxyglucose positron emission tomography\/CT before any treatment. Sarcopenia was measured as skeletal muscle index (SMI, cm<jats:sup>2<\/jats:sup>\/m<jats:sup>2<\/jats:sup>) by the analysis of high\u2010dose CT or low\u2010dose positron emission tomography\/CT images at the L3 level. The specific cut\u2010offs for the SMI were determined by receiver operator curve analysis and compared with those proposed in literature and studied in diffuse large B\u2010cell lymphoma. Survival functions [progression\u2010free survival [PFS] and overall survival (OS)] were calculated for the whole population and for different subgroups defined as per different sarcopenia cut\u2010off levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 154 patients (median age 71\u00a0years old, 76 female). The median L3\u2010SMI was 42\u00a0cm<jats:sup>2<\/jats:sup>\/m<jats:sup>2<\/jats:sup>. The specific cut\u2010off derived in our male population was 45\u00a0cm<jats:sup>2<\/jats:sup>\/m<jats:sup>2<\/jats:sup>; using this cut\u2010off, 27 male patients (35%) were defined as sarcopenic. After a median follow\u2010up of 5.9\u00a0years, the overall 5\u2010year PFS and OS rates were 53% and 65%, respectively, and were significantly shorter in sarcopenic male patients compared with non\u2010sarcopenic (PFS 31% vs. 61%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.008; OS 51% vs. 74%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.042). Applying diffuse large B\u2010cell lymphoma\u2010derived sarcopenic thresholds, there were no significant differences between sarcopenic and non\u2010sarcopenic patients for both PFS and OS, with a sole exception of a significant reduced PFS in sarcopenic male patients using Namakura cut\u2010off. The comprehensive geriatric assessment\u2010determined frail functional status was an independent adverse prognostic factor for both female and male patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Baseline evaluation of sarcopenia through radiological examinations performed for ecHL staging may help define a proportion of male patients with unfavourable outcome with current treatment strategies. Also the functional status evaluation could allow to identify a frail subgroup of patients with worse outcome.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.12736","type":"journal-article","created":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T10:42:23Z","timestamp":1623408143000},"page":"1042-1055","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Clinical and prognostic role of sarcopenia in elderly patients with classical Hodgkin lymphoma: a multicentre experience"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6915-2246","authenticated-orcid":false,"given":"Vittorio Ruggero","family":"Zilioli","sequence":"first","affiliation":[{"name":"Division of Hematology ASST Grande Ospedale Metropolitano Niguarda  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Albano","sequence":"additional","affiliation":[{"name":"Division of 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Modena and Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Marcheselli","sequence":"additional","affiliation":[{"name":"Fondazione Italiana Linfomi Onlus Trial Office Modena  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doriana","family":"Gramegna","sequence":"additional","affiliation":[{"name":"Division of Hematology ASST Spedali Civili  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Muzi","sequence":"additional","affiliation":[{"name":"Division of Hematology ASST Grande Ospedale Metropolitano Niguarda  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moana","family":"Manicone","sequence":"additional","affiliation":[{"name":"Clinical and Experimental PhD Program University of Modena and Reggio Emilia  Modena Italy"},{"name":"Division of Radiotherapy Azienda USL\u2014IRCCS di Reggio Emilia  Reggio Emilia 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