Skip to main content
SpringerLink
Log in

Clinical impact of sarcopenia and relevance of nutritional intake in patients before and after allogeneic hematopoietic stem cell transplantation

  • Original Article – Clinical Oncology
  • Published:
Journal of Cancer Research and Clinical Oncology Aims and scope Submit manuscript

Abstract

Purpose

We conducted a retrospective study to evaluate the effect of rehabilitation on minimizing sarcopenia during hematopoietic stem cell transplantation (HSCT) therapy.

Methods

We developed a protocol to test for retention of physical function during HSCT. Muscle strength, muscle circumference, and muscle function before and after HSCT were measured. Consecutive patients with hematological malignancies who underwent HSCT treatment were recruited in this research.

Results

We included 34 patients (16 females, 18 males; median age, 51.5 years). Bodyweight significantly decreased after HSCT (p < 0.001). Nine females and three males had sarcopenia prior to allogeneic HSCT. After HSCT, bilateral hand grip strength and bilateral knee extensor strength decreased significantly. The total caloric intakes for pre-conditioning, during preparation regimen, and after transplant were 1709, 1024, and 1445 kcal, respectively, and were significantly attenuated in the post-transplant period. Serum albumin was significantly decreased in the final period. Conversely, C-reactive protein was slightly but significantly increased across the transplantation process. Multivariate regression analysis revealed that oral caloric intake after the transplantation period and sex were significantly related to muscle weakness (p = 0.033 and 0.036, respectively).

Conclusions

Sarcopenia during HSCT was affected by oral caloric intake during the preparation regimen and after transplantation. Physical therapy in conjunction with nutritional therapy may help prevent weakness in HSCT recipients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

Alb:

Albumin

BMI:

Body mass index

BU:

Busulfan

CRP:

C-reactive protein

CY:

Cyclophosphamide

GVHD:

Graft-versus-host disease

HLA:

Human leukocyte antigen

HSCT:

Hematopoietic stem cell transplantation

IBW:

Ideal body weight

IRB:

Institutional review board

METs:

Metabolic equivalents

TBI:

Total body irradiation

QOL:

Quality of life

References

  • Bamman MM, Clarke MS, Feeback DL, Talmadge RJ, Stevens BR, Lieberman SA, Greenisen MC. (1998) Impact of resistance exercise during bed rest on skeletal muscle sarcopenia and myosin isoform distribution. J Appl Physiol 84:157–163

    CAS  PubMed  Google Scholar 

  • Coleman EA, Coon S, Hall-Barrow J, Richards K, Gaylor D, Stewart B (2003) Feasibility of exercise during treatment for multiple myeloma. Cancer Nurs 26:410–419

    Article  PubMed  Google Scholar 

  • Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM, Topinková E, Vandewoude M, Zamboni M, European Working Group on Sarcopenia in Older People (2010) Sarcopenia: european consensus on definition and diagnosis: report of the european working group on sarcopenia in older people. Age Ageing 39:412–423

    Article  PubMed  PubMed Central  Google Scholar 

  • Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, Jatoi A, Loprinzi C, MacDonald N, Mantovani G, Davis M, Muscaritoli M, Ottery F, Radbruch L, Ravasco P, Walsh D, Wilcock A, Kaasa S, Baracos VE (2011) Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 12:489–495

    Article  PubMed  Google Scholar 

  • Fujiwara N, Nakagawa H, Kudo Y, Tateishi R, Taguri M, Watadani T, Nakagomi R, Kondo M, Nakatsuka T, Minami T, Sato M, Uchino K, Enooku K, Kondo Y, Asaoka Y, Tanaka Y, Ohtomo K, Shiina S, Koike K (2015) Sarcopenia, intramuscular fat deposition, and visceral adiposity independently predict the outcomes of hepatocellular carcinoma. J Hepatol 63:131–140

    Article  CAS  PubMed  Google Scholar 

  • Gerber LH (1998) Rehabilitation for patients with cancer diagnoses, rehabilitation medicine: principles and practice, 3rd edn, vol 52, Lippincott Williams & Wilkins, Philadelphia, pp 1295–1296

    Google Scholar 

  • Harousseau JL (2007) The allogeneic dilemma. Bone Marrow Transpl 40:1123–1128

    Article  CAS  Google Scholar 

  • Inoue J, Ono R, Okamura A, Matsui T, Takekoshi H, Miwa M, Kurosaka M, Saura R, Shimada T (2010) The impact of early rehabilitation on the duration of hospitalization in patients after allogeneic hematopoietic stem cell transplantation. Transpl Proc 42:2740–2744

    Article  CAS  Google Scholar 

  • Jarden M, Baadsgaard MT, Hovgaard DJ, Boesen E, Adamsen L (2009) A randomized trial on the effect of a multimodal intervention on physical capacity, functional performance and quality of life in adult patients undergoing allogeneic SCT. Bone Marrow Transpl 43:725–737

    Article  CAS  Google Scholar 

  • Kovalszki A, Schumaker GL, Klein A, Terrin N, White AC (2008) Reduced respiratory and skeletal muscle strength in survivors of sibling or unrelated donor hematopoietic stem cell transplantation. Bone Marrow Transpl 41:965–969

    Article  CAS  Google Scholar 

  • Kramer M, Heussner P, Herzberg PY, Andree H, Hilgendorf I, Leithaeuser M, Junghanss C, Freund M, Wolff D (2013) Validation of the grip test and human activity profile for evaluation of physical performance during the intermediate phase after allogeneic hematopoietic stem cell transplantation. Support Care Cancer 21:1121–1129

    Article  PubMed  Google Scholar 

  • Lee HJ, Oran B, Saliba RM, Couriel DM, Shin K, Massey P, Neumann J, de Lima M, Champlin R, Giralt S (2006) Steroid myopathy in patients with acute graft-versus-host disease treated with high-dose steroid therapy. Bone Marrow Transpl 38:299–303

    Article  CAS  Google Scholar 

  • Malietzis G, Aziz O, Bagnall NM, Johns N, Fearon KC, Jenkins JT (2015) The role of body composition evaluation by computerized tomography in determining colorectal cancer treatment outcomes: a systematic review. Eur J Surg Oncol 41:186–196

    Article  CAS  PubMed  Google Scholar 

  • Mello M, Tanaka C, Dulley FL (2003) Effects of an exercise program on muscle performance in patients undergoing allogeneic bone marrow transplantation. Bone Marrow Transpl 32:723–728

    Article  CAS  Google Scholar 

  • Morishita S, Kaida K, Ikegame K, Yoshihara S, Taniguchi K, Okada M, Kodama N, Ogawa H, Domen K (2012) Impaired physiological function and health-related QOL in patients before hematopoietic stem-cell transplantation. Support Care Cancer 20:821–829

    Article  PubMed  Google Scholar 

  • Prado CM, Lieffers JR, McCargar LJ, Reiman T, Sawyer MB, Martin L, Baracos VE (2008) Prevalence and clinical implications of sarcopenic obesity in patients with solid tumors of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol 9:629–635

    Article  PubMed  Google Scholar 

  • Przepiorka D, Weisdorf D, Martin P, Klingemann HG, Beatty P, Hows J, Thomas ED (1995) 1994 consensus conference on acute gvhd grading. Bone Marrow Transpl 15:825–828

    CAS  Google Scholar 

  • Sarkozy C, Camus V, Tilly H, Salles G, Jardin F (2015) Body mass index and other anthropometric parameters in patients with diffuse large B-cell lymphoma: physiopathological significance and predictive value in the immunochemotherapy era. Leuk Lymphoma 56:1959–1968

    Article  PubMed  Google Scholar 

  • Tan BH, Birdsell LA, Martin L, Baracos VE, Fearon KC (2009) Sarcopenia in an overweight or obese patient is an adverse prognostic factor in pancreatic cancer. Clin Cancer Res 15:6973–6979

    Article  CAS  PubMed  Google Scholar 

  • van Haren IE, Timmerman H, Potting CM, Blijlevens NM, Staal JB, Nijhuis-van der Sanden MW (2013) Physical exercise for patients undergoing hematopoietic stem cell transplantation: systematic review and meta-analyses of randomized controlled trials. Phys Ther 93:514–528

    Article  PubMed  Google Scholar 

  • Wiskemann J, Huber G (2008) Physical exercise as adjuvant therapy for patients undergoing hematopoietic stem cell transplantation. Bone Marrow Transpl 41:321–329

    Article  CAS  Google Scholar 

  • Yamada E, Kusaka T, Miyamoto K, Tanaka S, Morita S, Tanaka S, Tsuji S, Mori S, Norimatsu H, Itoh S (2005) Vastus lateralis oxygenation and blood volume measured by near-infrared spectroscopy during whole body vibration. Clin Physiol Funct Imaging 25:203–208

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Rehabilitation, Faculty of Medicine, Kagawa University, Kagawa, Japan

    Shouichi Tanaka & Shuji Fujioka

  2. Division of Hematology and Stem Cell Transplantation, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan

    Osamu Imataki & Makiko Uemura

  3. Division of Clinical Nutrition, Faculty of Medicine, Kagawa University, Kagawa, Japan

    Atsuo Kitaoka & Etsuyo Hanabusa

  4. Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan

    Yumiko Ohbayashi

  5. Department of Orthopedic Surgery, Sanuki Municipal Hospital, Kagawa, Japan

    Nobuo Arima

  6. Department of Orthopedic Surgery, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan

    Tetsuji Yamamoto

Authors
  1. Shouichi Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Osamu Imataki
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Atsuo Kitaoka
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shuji Fujioka
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Etsuyo Hanabusa
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yumiko Ohbayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Makiko Uemura
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Nobuo Arima
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Tetsuji Yamamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tetsuji Yamamoto.

Ethics declarations

Conflict of interest

We have no conflicts of interest to disclose.

Author’s disclosure

This manuscript has not been published elsewhere nor is it under consideration by another journal. All authors approved the manuscript and agreed with its submission to your journal.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tanaka, S., Imataki, O., Kitaoka, A. et al. Clinical impact of sarcopenia and relevance of nutritional intake in patients before and after allogeneic hematopoietic stem cell transplantation. J Cancer Res Clin Oncol 143, 1083–1092 (2017). https://doi.org/10.1007/s00432-016-2336-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00432-016-2336-8

Keywords

Search

Navigation