Risks of Sarcopenia in Patients with Hematological and Oncological Factors who Underwent Hematopoietic Stem Cell Transplantation

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  • Hirota Keisuke
    Division of Rehabilitation, Kurume University Hospital
  • Matsuse Hiroo
    Division of Rehabilitation, Kurume University Hospital Department of Orthopedics, Kurume University School of Medicine
  • Hashida Ryuki
    Division of Rehabilitation, Kurume University Hospital Department of Orthopedics, Kurume University School of Medicine
  • Iwanaga Sohei
    Division of Rehabilitation, Kurume University Hospital Department of Orthopedics, Kurume University School of Medicine
  • Nagafuji Koji
    Department of Hematology and Oncology, Internal Medicine, Kurume University School of Medicine
  • Shiba Naoto
    Division of Rehabilitation, Kurume University Hospital Department of Orthopedics, Kurume University School of Medicine

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  • 血液腫瘍疾患における造血幹細胞移植後の骨格筋量変化とその要因
  • ケツエキ シュヨウ シッカン ニ オケル ゾウケツ カンサイボウ イショク ゴ ノ コッカクキンリョウ ヘンカ ト ソノ ヨウイン

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Abstract

<p>Background and Aims：Sarcopenia is associated with autologous hematopoietic stem cell transplantation (auto-HSCT) -related outcomes in patients with malignant lymphoma (ML). The aims of this study were to investigate changes in skeletal muscle mass after auto-HSCT and risk profiles for sarcopenia after HSCT.</p><p>Methods：We enrolled 25 patients with refractory ML (age, 57 years [20-69 years]；female/male, 11/14；body mass index, 21.7 kg/m2 [18.9-29.6 kg/m2]). Skeletal muscle mass was evaluated using the psoas muscle index (PMI) measured on computed tomography before and after auto-HSCT. In addition, visceral fat area (VFA) was also measured. Independent factors and profiles associated with a decrease in PMI were evaluated using multivariate and decision-tree analyses, respectively.</p><p>Results：The PMI was significantly decreased after auto-HSCT (p＝0.0288). A logistic regression analysis revealed that the decreases in PMI and VFA were related. According to the decision-tree analysis, the PMI measured prior to auto-HSCT was selected as the initial branch. Of the patients with a PMI of＜3.74 cm2/m2, 84％ showed a decrease in PMI. Of the patients with a PMI of ≥3.74 cm2/m2, the VFA measured prior to auto-HSCT was the second branch. All the patients with a VFA of ≥115.0 cm2 had decreased PMI.</p><p>Conclusions：We demonstrated that skeletal muscle mass decreased after auto-HSCT in the patients with ML. The patients with either a PMI of＜3.74 cm2/m2 or a VFA of ≥105.0 cm2 before auto-HSCT were at risk of decreased skeletal muscle mass.</p>

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