Prevalence and significance of sarcopenia in multiple myeloma patients undergoing autologous hematopoietic cell transplantation. Bone Marrow Transplant 2021 Jan;56(1):225-231
Date
08/01/2020Pubmed ID
32732941Pubmed Central ID
PMC7855279DOI
10.1038/s41409-020-01008-9Scopus ID
2-s2.0-85088830942 (requires institutional sign-in at Scopus site) 19 CitationsAbstract
Sarcopenia, defined as loss of muscle mass, can occur with aging. We conducted a single-center retrospective analysis to evaluate the impact of muscle quality in multiple myeloma (MM), a hematologic cancer of older adults, undergoing autologous hematopoietic cell transplantation (autoHCT). Healthy muscle was quantified by measuring the percent of high-density muscle within the L3 psoas muscle using a novel computed tomography method in 142 eligible patients. Early post-transplant complications were assessed in the first 100 days after transplant. Sarcopenia, defined as ≤80% high-density muscle, was found in 72 (51%) patients. Sarcopenic obesity, defined as sarcopenia and a BMI ≥ 30, was found in 32 (23%) patients. One or more early complications occurred in 22 (16%) patients. Cardiovascular events accounted for 36% of all complications. Patients with sarcopenia had more cardiac complications (12.5%) than patients without (2.9%, p = 0.03). Multivariate analysis revealed increased BMI at transplant, but not sarcopenia, was associated with worse OS (hazard ratio: 1.11, 95% confidence interval: 1.02-1.22, p = 0.02). Our analysis suggests that sarcopenia is prevalent in MM and associated with increased early post-transplant cardiovascular complications in MM. Obesity, regardless of sarcopenia, is associated with worse survival in MM. Our study generates hypothesis-generating data to risk-stratify patients being considered for autoHCT.
Author List
Williams A, Baruah D, Patel J, Szabo A, Chhabra S, Dhakal B, Hari P, Janz S, Stolley M, D'Souza AAuthors
Anita D'Souza MD Associate Professor in the Medicine department at Medical College of WisconsinBinod Dhakal MD Associate Professor in the Medicine department at Medical College of Wisconsin
Parameswaran Hari MD Adjunct Professor in the Medicine department at Medical College of Wisconsin
Siegfried Janz MD Professor in the Medicine department at Medical College of Wisconsin
Melinda Stolley PhD Center Associate Director, Professor in the Medicine department at Medical College of Wisconsin
Aniko Szabo PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AgedHematopoietic Stem Cell Transplantation
Humans
Multiple Myeloma
Prevalence
Retrospective Studies
Sarcopenia
Tomography, X-Ray Computed