Terao Yusuke, Nakayama Yasuhide, Abo Masahiro, Otobe Yuhei, Suzuki Mizue, Kojima Iwao, Tanaka Shu, Koyama Shingo, Kusumi Haruhiko, Yamada Minoru
Department of Rehabilitation Medicine, The Jikei University School of Medicine Hospital, Tokyo, Japan.
Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan.
Support Care Cancer. 2024 Jul 13;32(8):512. doi: 10.1007/s00520-024-08729-3.
Skeletal muscle function is an important prognostically relevant indicator in patients with acute leukemia (AL), but skeletal dysfunction during chemotherapy is not well understood. This study aimed to investigate the factors that influence changes in skeletal muscle function from before the start of chemotherapy to before allogeneic hematopoietic stem cell transplantation (allo-HSCT).
This was a retrospective cohort study that included 90 patients with AL who underwent chemotherapy before transplantation to perform allo-HSCT (men, 67.3%; median age, 53 years). The outcome measure was defined as changes in skeletal muscle function from before chemotherapy to before allo-HSCT, and was assessed by measuring the psoas muscle index (PMI) as skeletal muscle quantity and computed tomography values (CTV) as skeletal muscle quality using a computed tomography scanner. We examined the differences in PMI and CTV before chemotherapy and allo-HSCT, and the factors associated with changes in PMI.
The mean PMI for before chemotherapy and allo-HSCT were 4.6 ± 1.4 cm/m and 4.0 ± 1.3 cm/m and significant differences were observed (p < 0.001). However, the mean CTV before chemotherapy and allo-HSCT were 47.3 ± 4.5 HU and 47.4 ± 5.0 HU, respectively, and no significant differences were found (p = 0.798). In stepwise multiple regression analysis, age and sex were identified as factors related to changes in PMI (age, p = 0.019; sex, p = 0.001).
We found that skeletal muscle quantity decreased during chemotherapy in patients with AL and was influenced by male sex and older age.
TRIAL REGISTRATION NUMBER: 34-096(11,243). Date of registration: September 11, 2023.
骨骼肌功能是急性白血病（AL）患者重要的预后相关指标，但化疗期间的骨骼功能障碍尚未得到充分了解。本研究旨在调查从化疗开始前到异基因造血干细胞移植（allo-HSCT）前影响骨骼肌功能变化的因素。
这是一项回顾性队列研究，纳入了90例在移植前行化疗以进行allo-HSCT的AL患者（男性占67.3%；中位年龄53岁）。结局指标定义为从化疗前到allo-HSCT前骨骼肌功能的变化，通过使用计算机断层扫描扫描仪测量腰大肌指数（PMI）作为骨骼肌数量以及计算机断层扫描值（CTV）作为骨骼肌质量来评估。我们检查了化疗前和allo-HSCT前PMI和CTV的差异，以及与PMI变化相关的因素。
化疗前和allo-HSCT前的平均PMI分别为4.6±1.4 cm/m和4.0±1.3 cm/m，观察到显著差异（p<0.001）。然而，化疗前和allo-HSCT前的平均CTV分别为47.3±4.5 HU和47.4±5.0 HU，未发现显著差异（p = 0.798）。在逐步多元回归分析中，年龄和性别被确定为与PMI变化相关的因素（年龄，p = 0.019；性别，p = 0.001）。
我们发现AL患者化疗期间骨骼肌数量减少，且受男性性别和年龄较大的影响。
试验注册号：34 - 096(11,243)。注册日期：2023年9月11日。
