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CT 定义的身体成分作为多发性骨髓瘤的预后因素。

CT-defined body composition as a prognostic factor in multiple myeloma.

机构信息

Department of Radiology and Nuclear Medicine, University of Magdeburg, Magdeburg, Germany.

Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University, Bochum, Germany.

出版信息

Hematology. 2023 Dec;28(1):2191075. doi: 10.1080/16078454.2023.2191075.

Abstract

OBJECTIVES

Body composition assessment is comprised by skeletal muscle mass (SMM) and subcutaneous and visceral adipose tissue (SAT and VAT) and can be quantified by imaging. It can be predictive of several clinically outcomes in patients with hematological diseases. Our aim was to establish the effect of body composition parameters on overall survival (OS) and progression-free survival (PFS) in patients with multiple myeloma (MM).

MATERIALS AND METHODS

All patients with MM were retrospectively analyzed between 2009 and 2019. One hundred twenty-three patients were included into the analysis. Whole-body computed tomography (CT) was used to calculate SMM, VAT, and SAT.

RESULTS

Overall, 22 patients (17.9%) of the patient sample died. Forty patients were sarcopenic (32.5%), 79 patients were visceral obese (64.2%), and 18 patients (14.6%) were sarcopenic obese. Parameter of body composition did not influence OS: sarcopenia, hazard ratio (HR) = 1.3 (95% CI 0.50-3.34),  = .59; visceral obesity, HR = 1.6 (95% CI 0.70-3.76),  = .26; sarcopenic obesity, HR = 2.3 (95% CI 0.90-5.63),  = 0.08. Patients with infectious complications showed higher VAT values.

CONCLUSIONS

CT-defined body composition parameters have no influence on survival in patients with MM undergoing autologous stem-cell therapy. These results corroborate previous smaller studies that body composition might have a limited role in this tumor entity. VAT may predict the occurrence of infectious complications.

摘要

目的

人体成分评估包括骨骼肌质量(SMM)以及皮下和内脏脂肪组织(SAT 和 VAT),并可通过影像学进行量化。它可以预测血液病患者的多种临床结果。我们的目的是确定人体成分参数对多发性骨髓瘤(MM)患者总生存(OS)和无进展生存(PFS)的影响。

材料和方法

回顾性分析了 2009 年至 2019 年间所有 MM 患者。共纳入 123 例患者进行分析。全身计算机断层扫描(CT)用于计算 SMM、VAT 和 SAT。

结果

总体而言,患者样本中有 22 例(17.9%)死亡。40 例患者存在肌肉减少症(32.5%),79 例患者存在内脏肥胖(64.2%),18 例患者存在肌肉减少症合并内脏肥胖(14.6%)。人体成分参数对 OS 没有影响:肌肉减少症,危险比(HR)=1.3(95%CI 0.50-3.34),P=.59;内脏肥胖,HR=1.6(95%CI 0.70-3.76),P=.26;肌肉减少症合并内脏肥胖,HR=2.3(95%CI 0.90-5.63),P=.08。发生感染性并发症的患者 VAT 值较高。

结论

接受自体干细胞治疗的 MM 患者,CT 定义的人体成分参数对生存无影响。这些结果与先前较小的研究结果一致,即人体成分在这种肿瘤实体中的作用可能有限。VAT 可能预测感染性并发症的发生。

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