Jia Shuli, Qiao Runjuan, Xiao Yuting, Qin Dan, Zhao Wanyu, Zhao Yunli, Liu Xiaolei, Dong Birong
Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041, Sichuan, China.
Support Care Cancer. 2020 Aug;28(8):3533-3542. doi: 10.1007/s00520-020-05359-3. Epub 2020 Feb 23.
Sarcopenia is increasingly recognized as an independent risk factor for poor outcomes in patients undergoing hematopoietic stem cell transplantation (HSCT), and it is a potentially modifiable factor. The purpose of the present systematic review and meta-analysis is to summarize and integrate current evidence in this field.
We searched EMBASE, MEDLINE, and Cochrane DSR through Ovid and PubMed websites to identify relevant studies. Studies evaluated sarcopenia before HSCT and reported associations between sarcopenia and post-transplant outcomes were included. Two authors independently applied eligibility criteria, assessed quality, and extracted data. Odds ratio (OR) and their 95% confidence intervals (CIs) were pooled to examine the association between sarcopenia and post-transplant outcomes by using the review manager 5.3 software.
Seven retrospective cohort studies met our inclusion criteria. The overall quality of studies was low to moderate. Sarcopenia was associated with higher non-relapse mortality [odds ratio (OR) 1.97; 95% CI 1.45, 2.68; P < 0.0001; I = 0%] and shorter overall survival [odds ratio (OR) 0.44; 95% CI 0.26, 0.75; P = 0.002; I = 65%] in patients undergoing HSCT.
Clinicians could use sarcopenia to balance the risks and benefits of transplantation as early as possible; in addition, interventions can be used to prevent sarcopenia and improve physical function and quality of life. Well-designed, prospective, and large-scale clinical studies are needed to consolidate the evidence.
肌肉减少症日益被认为是造血干细胞移植（HSCT）患者预后不良的独立危险因素，并且是一个潜在的可改变因素。本系统评价和荟萃分析的目的是总结和整合该领域的现有证据。
我们通过Ovid和PubMed网站检索了EMBASE、MEDLINE和Cochrane系统评价数据库，以识别相关研究。纳入在HSCT前评估肌肉减少症并报告肌肉减少症与移植后结局之间关联的研究。两位作者独立应用纳入标准、评估质量并提取数据。使用Review Manager 5.3软件汇总比值比（OR）及其95%置信区间（CI），以检验肌肉减少症与移植后结局之间的关联。
七项回顾性队列研究符合我们的纳入标准。研究的总体质量为低到中等。在接受HSCT的患者中，肌肉减少症与较高的非复发死亡率[比值比（OR）1.97；95%CI 1.45，2.68；P < 0.0001；I² = 0%]和较短的总生存期[比值比（OR）0.44；95%CI 0.26，0.75；P = 0.002；I² = 65%]相关。
临床医生可以尽早利用肌肉减少症来平衡移植的风险和益处；此外，可以采用干预措施来预防肌肉减少症并改善身体功能和生活质量。需要设计良好的前瞻性大规模临床研究来巩固证据。
