Department of Rehabilitation, Osaka International Cancer Institute, Osaka, Japan.
Department of Hematology, Osaka International Cancer Institute, Osaka, Japan.
PM R. 2024 Jun;16(6):570-585. doi: 10.1002/pmrj.13083. Epub 2024 Feb 1.
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative treatment for hematological malignancies. Several complications following allo-HSCT, such as graft-versus-host disease, infection, and malnutrition, often cause physical dysfunction, and the assessment of physical function and evaluation of muscle mass are incompletely performed. Use of ultrasound (US) allows muscle mass measurement in patients with poor general conditions. In allo-HSCT recipients, the correlation between physical function and muscle thickness, as measured by US, remains unclear.
To clarify whether muscle thickness measured by US correlated with physical function in allo-HSCT recipients.
A single-center prospective cohort study.
Hospital.
Ninety-two patients underwent allo-HSCT at our hospital from April 2017 to March 2019.
Not applicable.
MAIN OUTCOME MEASURE(S): Biceps and quadriceps muscle thickness measured by US, grip strength, isometric muscle strength (elbow flexion and knee extension), and 6-minute walking test (6MWT) before allo-HSCT and on days 30, 90, 180, 1 year, and 2 years after allo-HSCT. The implementation rates of these assessments were also investigated.
Correlations were observed between biceps thickness and elbow flexion muscle strength/grip strength before allo-HSCT, on days 30, 90, 180, 1 year, and 2 years after allo-HSCT (r = 0.71/0.74, 0.73/0.72, 0.70/0.79, 0.67/0.75, 0.72/0.75, and 0.85/0.79, respectively, all p < .001). At the same time points, quadriceps thickness moderately correlated with knee extensor strength (r = 0.49, 0.50, 0.45, 0.64, 0.61, and 0.58, all p < .001). However, biceps and quadriceps thicknesses did not correlate with the 6MWT. The percentages of patients measured with US and 6MWT were 93.4% and 82.4% (p = .01) on day 30 and 97.5% and 87.8% (p = .02) on day 90, respectively.
US assessment may be a useful alternative method for estimating muscle strength in fragile allo-HSCT recipients, particularly when physical function assessment is difficult to quantify.
异基因造血干细胞移植（allo-HSCT）是治疗血液系统恶性肿瘤的一种潜在的根治性治疗方法。allo-HSCT 后会出现多种并发症，如移植物抗宿主病、感染和营养不良，这些并发症常导致身体功能障碍，且肌肉量的评估和物理功能评估往往不完整。超声（US）的使用可以在身体状况不佳的患者中测量肌肉量。在 allo-HSCT 受者中，US 测量的肌肉厚度与身体功能之间的相关性尚不清楚。
明确 allo-HSCT 受者中 US 测量的肌肉厚度与身体功能是否相关。
单中心前瞻性队列研究。
医院。
2017 年 4 月至 2019 年 3 月，我院 92 例患者行 allo-HSCT。
无。
allo-HSCT 前、allo-HSCT 后 30、90、180、1 年和 2 天的肱二头肌和股四头肌厚度，握力，等长肌肉力量（肘屈肌和伸膝肌）和 6 分钟步行试验（6MWT）。还调查了这些评估的实施率。
allo-HSCT 前、allo-HSCT 后 30、90、180、1 年和 2 天的肱二头肌厚度与肘屈肌和握力均呈正相关（r=0.71/0.74、0.73/0.72、0.70/0.79、0.67/0.75、0.72/0.75 和 0.85/0.79，均 p<0.001）。同时，股四头肌厚度与伸膝肌强度中度相关（r=0.49、0.50、0.45、0.64、0.61 和 0.58，均 p<0.001）。然而，肱二头肌和股四头肌厚度与 6MWT 不相关。第 30 天 US 测量和 6MWT 的患者百分比分别为 93.4%和 82.4%（p=0.01），第 90 天分别为 97.5%和 87.8%（p=0.02）。
US 评估可能是一种有用的替代方法，可用于估计脆弱的 allo-HSCT 受者的肌肉力量，尤其是在难以量化身体功能评估时。
