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Risks of Muscle Atrophy in Patients with Malignant Lymphoma after Autologous Stem Cell Transplantation
Authors:Keisuke HIROTA  Hiroo MATSUSE  Shunji KOYA  Ryuki HASHIDA  Masafumi BEKKI  Yoko YANAGA  Kiyoko JOHZAKI  Mami TOMINO  Fumihiko MOURI  Satoshi MORISHIGE  Shuki OYA  Yoshitaka YAMASAKI  Koji NAGAFUJI  Naoto SHIBA
Institution:1.Division of Rehabilitation, Kurume University Hospital, Kurume, Japan; 2.Department of Orthopedics, Kurume University School of Medicine, Kurume, Japan; 3.Department of Nursing, Kurume University Hospital, Kurume, Japan; 4.Division of Hematology and Oncology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
Abstract:Objective: Muscle atrophy is associated with autologous stem cell transplantation (ASCT)-related outcomes in patients with malignant lymphoma (ML). However, the impact of ASCT on muscle mass remains unclear in patients with ML. The aims of this study were to investigate changes in muscle mass and risk profiles for muscle atrophy after ASCT. Method: We enrolled 40 patients with refractory ML (age 58 20-74] years, female/male 16/24, body mass index (BMI) 21.1 kg/m2 17.1-29.6]). Psoas muscle mass was assessed using the psoas muscle index (PMI) before and after ASCT. Statistical analysis used: Independent factors associated with a severe decrease rate of change in PMI were evaluated by decision-tree analysis, respectively. Results: PMI was significantly decreased after ASCT (4.61 vs. 4.55 cm2/m2; P=0.0425). According to the decision-tree analysis, the regimen was selected as the initial split. The rates of change in PMI were −5.57% and −3.97% for patients administered MCEC and LEED, respectively. In patients who were administered LEED, the second branching factor was BMI. In patients with BMI < 20.3 kg/m2, the rate of change in PMI was −7.16%. On the other hand, the rate of change in PMI was 4.05% for patients with BMI ≥ 20.3 kg/m2. Conclusion: We demonstrated that muscle mass decreased after ASCT in patients with ML. Patients who received MCEC and patients with low BMI were at risk for a decrease in muscle mass.
Keywords:muscle atrophy  sarcopenia  skeletal muscle index  hematopoietic stem cell transplantation  hematologic malignancies
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