Sarcopenia and clinical outcomes in lymphoma and multiple myeloma patients receiving hematopoietic cell transplantation: a systematic review and meta-analysis.

BACKGROUND

Sarcopenia, characterized by skeletal muscle loss, is increasingly recognized as a predictor of poor outcomes in hematologic malignancies. This study evaluated the impact of sarcopenia on survival and post-transplant outcomes in lymphoma and multiple myeloma patients undergoing hematopoietic cell transplantation (HCT).

METHODS

A systematic review of eleven retrospective studies (2015-2024) including 1866 patients was conducted. Sarcopenia was assessed by CT, with some variation in diagnostic criteria. Pooled analyses were conducted to examine associations with mortality, progression-free survival (PFS), and non-relapse mortality (NRM).

RESULTS

The overall prevalence of sarcopenia was 45.7% (lymphoma: 44.2%, multiple myeloma: 49%). Sarcopenia significantly increased mortality risk in lymphoma (HR 1.92, 95% CI 1.61-2.29, p < 0.00001) and multiple myeloma patients (HR 1.12, 95% CI 1.03-1.22, p = 0.01). PFS was worse in lymphoma patients (HR 2.40, 95% CI 1.44-4.36, p = 0.0009), but NRM did not differ significantly.

CONCLUSION

Sarcopenia is a significant risk factor for poor outcomes in HCT recipients. Routine assessment and targeted interventions, including nutritional and exercise strategies, may improve patient outcomes. Further prospective studies are needed to establish standardized diagnostic criteria and explore therapeutic interventions.