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Impact of muscle loss in children with hematologic malignancies undergoing allogeneic hematopoietic cell transplantation

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Abstract

The widespread recognition of the concept of sarcopenia, or muscle loss, has impacted the prognosis of patients undergoing high-intensity treatments. We focused on the effect of muscle loss on the prognosis of pediatric patients with hematologic diseases. A total of 65 patients with hematologic malignancies who underwent allogeneic HCT once were investigated. The change in cross-sectional psoas muscle area (PMA) measured on computed tomography (CT) images was expressed as the muscle loss index (MLI), which was calculated by dividing the pre-HCT PMA by the baseline PMA. In this study, patients with MLI values less than 0.85 were classified into the muscle loss group. Muscle loss was observed in 27 patients (41.5%). Patients who experienced muscle loss were older than those who did not. Muscle loss was an independent predictor of higher non-relapse mortality (NRM) (p = 0.012) and inferior overall survival (OS) (p = 0.045) at 5 years. Multivariate analysis showed that muscle loss was an independent risk factor for higher NRM (p = 0.046), and inferior EFS (p = 0.048). Muscle loss observed pre-HCT may be a predictor of increased NRM, poor OS and EFS in pediatric patients with hematologic malignancies undergoing allogeneic HCT.

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Abbreviations

HCT:

Hematopoietic cell transplantation

PMA:

Psoas muscle area

CT:

Computed tomography

MLI:

Muscle loss index

OS:

Overall survival

EFS:

Event-free survival

NRM:

Non-relapse mortality

References

  1. Rosenberg I. Summary comments. Am J Clin Nutr. 1989;50:1231–3.

    Article  Google Scholar 

  2. Tanaka S, Imataki O, Kitaoka A, Fujioka S, Hanabusa E, Ohbayashi Y, et al. Clinical impact of sarcopenia and relevance of nutritional intake in patients before and after allogeneic stem cell transplantation. J Cancer Res Clin Oncol. 2017;143:1083–92.

    Article  CAS  Google Scholar 

  3. Jia S, Qiao R, Xiao Y, Qin D, Zhao W, Zhao Y, et al. Prognostic value of sarcopenia in survivors of hematological malignances undergoing a hematopoetic stem cell transplantation: a systematic review and meta-analysis. Support Care Cancer. 2020;28:3533–42.

    Article  Google Scholar 

  4. Armenian SH, Xiao M, The JB, Lee B, Chang HA, Mascarenhas K, et al. Impact of sarcopenia on adverse outcomes after allogeneic hematopoietic cell transplantation. J Natl Cancer Inst. 2019;111:837–44.

    Article  Google Scholar 

  5. Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transpl. 2013;48:452–8.

    Article  CAS  Google Scholar 

  6. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39:412–23.

    Article  Google Scholar 

  7. Fielding RA, Vellas B, Evans WJ, Bhasin S, Morley JE, Newman AB, et al. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International Working Group on Sarcopenia. J Am Med Dir Assoc. 2011;12:249–56.

  8. Chen LK, Liu LK, Woo J, Assantachai P, Auyeung TW, Bahyah KS, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc. 2014;15:95–101.

    Article  Google Scholar 

  9. Hanaoka M, Yasuno M, Ishiguro M, Yamauchi S, Kikuchi A, Tokura M, et al. Morphologic change of the psoas muscle as a surrogate marker of sarcopenia and predictor of complications after colorectal cancer surgery. Int J Colorectal Dis. 2017;32:847–56.

    Article  Google Scholar 

  10. Ikeno Y, Koide Y, Abe N, Matsueda T, Izawa N, YamazatoT, et al. Impact of sarcopenia on the outcomes of elective total arch replacement in the elderly. Eur J Cardiothorac Surg. 2017;51:1135–41.

  11. Harada K, Suzuki S, Ishii H, Aoki T, Hirayama K, Shibata Y, et al. Impact of skeletal muscle mass on long-term adverse cardiovascular outcomes in patients with chronic kidney disease. Am J Cardiol. 2017;119:1275–80.

    Article  Google Scholar 

  12. Ando T, Fujisawa S, Teshigawara H, Matsumura A, Sakuma T, Suzuki T, et al. Computed-tomography-defined sarcopenia: prognostic predictor of nonrelapse mortality after allogeneic hematopoietic stem cell transplantation: a multicenter retrospective study. Int J Hematol. 2020;112:46–56.

    Article  CAS  Google Scholar 

  13. Suzuki D, Kobayashi R, Sano H, Hori D, Kobayashi K. Sarcopenia after induction therapy in childhood acute lymphoblastic leukemia: its clinical significance. Int J Hematol. 2018;107:486–9.

    Article  Google Scholar 

  14. Rezende IFB, Conceição-Machado MEP, Souza VS, Santos EMD, Silva LR. Sarcopenia in children and adolescents with chronic liver disease. J Pediatr. 2020;96:439–46.

    Article  Google Scholar 

  15. Ooi PH, Thompson-Hodgetts S, Pritchard-Wiart L, Gilmour SM, Mager DR. Pediatric Sarcopenia: A paradigm in the overall definition of malnutrition in children? JPEN J Parenter Enteral Nutr. 2020;44:407–18.

    Article  Google Scholar 

  16. Stene GB, Helbostad JL, Amundsen T, Sørhaug S, Hjelde H, Kaasa S, et al. Changes in skeletal muscle mass during palliative chemotherapy in patients with advanced lung cancer. Acta Oncol. 2015;54:340–8.

    Article  CAS  Google Scholar 

  17. Nakamura N, Kishimoto K, Ishida T, Nakamura S, Tamura A, Kozaki A, et al. Muscle mass change during chemotherapy in children with high-risk neuroblastoma: a retrospective case series of 24 patients. Eur J Pediatr. 2021;180:3265–71.

    Article  CAS  Google Scholar 

  18. Metzger GA, Carsel A, Sebastiao YV, Deans KJ, Minneci PC. Does sarcopenia affect outcomes in pediatric surgical patients? A scoping review J Pediatr Surg. 2021;56:2099–106.

    Article  Google Scholar 

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Funding

This research was not funded by any organization.

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Authors and Affiliations

  1. Department of Hematology/Oncology for Children and Adolescents, Sapporo Hokuyu Hospital, Sapporo, 003-0006, Japan

    Daisuke Suzuki, Ryoji Kobayashi, Masaki Yamamoto, Satoru Matsushima, Daiki Hori, Masato Yanagi, Koya Kodama, Hirozumi Sano & Kunihiko Kobayashi

  2. Department of Pediatrics, Tenshi Hospital, Kita 12 jo Higashi 3 Chome1-1, Higashi-ku, Sapporo, 065-8611, Japan

    Daisuke Suzuki

  3. Department of Pediatrics, Sapporo Medical University Hospital, Sapporo, 060-8543, Japan

    Yusuke Akane & Keita Igarashi

Authors
  1. Daisuke Suzuki
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  2. Ryoji Kobayashi
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  3. Masaki Yamamoto
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  4. Satoru Matsushima
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  5. Daiki Hori
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  6. Masato Yanagi
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  7. Koya Kodama
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  8. Hirozumi Sano
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  9. Yusuke Akane
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  11. Kunihiko Kobayashi
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Correspondence to Daisuke Suzuki.

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In addition, there are no possible conflicts of interest that affect the results of the study and the interpretation of the results, and the conduct of the study did not impair the rights and interests of the subjects.

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Suzuki, D., Kobayashi, R., Yamamoto, M. et al. Impact of muscle loss in children with hematologic malignancies undergoing allogeneic hematopoietic cell transplantation. Int J Hematol 117, 128–133 (2023). https://doi.org/10.1007/s12185-022-03462-1

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  • DOI: https://doi.org/10.1007/s12185-022-03462-1

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