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Skeletal muscle mass during chemotherapy for haematological malignancies: a retrospective study
  1. Mamiko Takahashi1,
  2. Shin Kondo2,
  3. Kumiko Kagawa3,
  4. Masafumi Nakamura1,
  5. Yusaku Maeda1,
  6. Ryohei Sumitani1,
  7. Hikaru Yagi1,
  8. Masahiro Oura1,
  9. Kimiko Sogabe1,
  10. Takeshi Harada1,
  11. Shiro Fujii1,
  12. Hirokazu Miki4,
  13. Itsuro Endo5,
  14. Masahiro Abe6 and
  15. Shingen Nakamura7
  1. 1 Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
  2. 2 Division of Rehabilitation, Tokushima University Hospital, Tokushima, Japan
  3. 3 Department of Hematology, Tokushima Prefecture Central Hospital, Tokushima, Japan
  4. 4 Division of Transfusion Medicine and Cell Therapy, Tokushima University Hospital, Tokushima, Japan
  5. 5 Department of Bioregulatory Sciences, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
  6. 6 Department of Hematology, Kawashima Hospital, Tokushima, Japan
  7. 7 Department of Community Medicine and Medical Sciences, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
  1. Correspondence to Dr Shingen Nakamura, Department of Community Medicine and Medical Sciences, University of Tokushima Graduate School of Biomedical Sciences, Tokushima, Tokushima, Japan; shingen{at}tokushima-u.ac.jp

Abstract

Objective This study investigated whether baseline or alteration in muscle mass affects complications during chemotherapy or overall survival (OS) in haematological malignancies.

Methods Skeletal Muscle Index (SMI) was evaluated by bioimpedance analysis before and after chemotherapy in patients with haematological malignancies, and the association between muscle mass and clinical data was retrospectively analysed.

Results Exactly 104 patients were enrolled, with a mean age of 62.2 years. SMI was 7.85 and 6.08 in male and female patients under 65 years and 7.10 and 5.92 over 65 years, before chemotherapy, respectively. Lower baseline SMI was not correlated with worse OS in total patients (p=0.915). After a median measurement interval of 30 days after chemotherapy (n=67), body weight and SMI decreased by 2.73% and 2.87% (mean), respectively. The decrease in body weight correlated with the loss of trunk muscle mass (R2=0.2107) but was more strongly associated with the loss of lower limbs muscle mass (R2=0.3985). The muscle mass of lower limbs significantly decreased in lymphoma patients who experienced febrile neutropenia (−0.42% vs −6.04%, p=0.040). OS significantly decreased in lymphoma patients with loss of lower limbs muscle ≥2.8% (p=0.0327).

Conclusions Muscle loss occurred following anticancer treatments, significantly contributing to worse outcomes. Body composition assessment and relevant multimodal prevention of muscle loss may be vital for patients receiving chemotherapy for haematological malignancies.

  • Lymphoma
  • Rehabilitation

https://doi.org/10.1136/spcare-2024-004870

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    Footnotes

    • Contributors Conceptualisation: MT, SK and SN; Data acquisition and processing: MT, KK, SN and SK; Clinical work for the patient: MT, SN, KK, MN, YM, RS, HY, MO, KS, TH, SF and HM; Writing—original draft preparation: MT and SN; Writing—revised draft and editing: IE and MA; Manuscript supervision: IE and MA; Project administration: MT and SN. All authors have read and agreed to the published version of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests MA received research funding from Chugai Pharmaceutical and Sanofi; KK from Pfizer; Seiyaku KK and Kyowa Hakko Kirin from Janssen Pharma; KK from Takeda Pharmaceutical, Teijin Pharma, Ono Pharmaceutical and honoraria from the Daiichi Sankyo Company. SN and MT declare no conflicts of interest.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.