Oncology and Hematology Department, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Preventive Medicine, UNIFESP, São Paulo, Brazil.
JPEN J Parenter Enteral Nutr. 2021 Sep;45(7):1597-1603. doi: 10.1002/jpen.2048. Epub 2021 Mar 26.
Many studies have shown the importance of body composition parameters, muscle, and fat mass, evaluated by several methods in hematopoietic stem cell transplantation (HSCT) outcomes. Ultrasound (US) is an efficient and low-cost method to evaluate body composition, even though there have not been many studies in HSCT.
Our goal was to investigate the muscle, visceral fat (VF), and echogenicity before HSCT and after engraftment, evaluated by US and its association with outcomes.
All adult patients with hematological malignances admitted for HSCT autologous and allogeneic were eligible to enter this prospective study. Their thigh muscle thickness, VF, and echogenicity were evaluated by US on the first day of hospitalization (baseline) and after engraftment (15-25 days post-HSCT).
We evaluated 50 patients; 42% were male and 58% had undergone allogeneic HSCT. Most patients were <55 years old (68%) and had normal body mass index (50%). We found a significant reduction of right and left muscle thickness (P < .001) and echogenicity (P = .002) after engraftment compared with baseline. Our elderly patients had significantly bigger right-thigh muscle thickness (P = .02) and more VF (P = .009). The following data were higher in obese patients: right and left muscle thickness (P < .001), VF (P = .003), and echogenicity (P = .04). Death in the first 100 days had a positive association with obesity (P = 0.001) and VF (P = .002). VF was the only variable independent of HSCT type and age in mortality risk.
Obesity and VF had an important impact in mortality. US could be a useful tool and strategy for evaluating body composition in HSCT patients.
许多研究已经表明，身体成分参数（肌肉和脂肪质量）在造血干细胞移植（HSCT）结果中非常重要，这些参数可以通过多种方法进行评估。超声（US）是一种有效的、低成本的方法，可以评估身体成分，尽管在 HSCT 中应用并不多。
我们的目标是研究肌肉、内脏脂肪（VF）和移植后回声强度，通过 US 进行评估，并探讨其与结果的关系。
所有因自体和异体 HSCT 而住院的血液系统恶性肿瘤成年患者都有资格参加这项前瞻性研究。在入院当天（基线）和移植后（HSCT 后 15-25 天），通过 US 评估大腿肌肉厚度、VF 和回声强度。
我们共评估了 50 例患者，其中 42%为男性，58%接受了异体 HSCT。大多数患者年龄<55 岁（68%），BMI 正常（50%）。与基线相比，移植后右、左肌肉厚度（P<0.001）和回声强度（P=0.002）均显著降低。我们发现老年患者右侧大腿肌肉厚度（P=0.02）和 VF （P=0.009）明显更大。肥胖患者的右、左肌肉厚度（P<0.001）、VF （P=0.003）和回声强度（P=0.04）更高。100 天内死亡与肥胖（P=0.001）和 VF （P=0.002）呈正相关。VF 是与 HSCT 类型和年龄无关的死亡的独立危险因素。
肥胖和 VF 对死亡率有重要影响。US 可能是评估 HSCT 患者身体成分的有用工具和策略。
