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Original research
Allogeneic haematopoietic stem cell transplantation—clinical outcomes: impact of leg muscle strength
  1. Shin Kondo1,2,
  2. Kumiko Kagawa3,
  3. Takashi Saito1,2,
  4. Masahiro Oura3,
  5. Kimiko Sogabe3,
  6. Takeshi Harada3,
  7. Shiro Fujii3,
  8. Shingen Nakamura3,
  9. Hirokazu Miki4,
  10. Nori Sato5,
  11. Rei Ono2,
  12. Masahiro Abe3 and
  13. Shinsuke Katoh5
  1. 1Division of Rehabilitation, Tokushima University Hospital, Tokushima, Tokushima, Japan
  2. 2Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Hyogo, Japan
  3. 3Department of Hematology, Tokushima University Hospital, Tokushima, Japan
  4. 4Division of Transfusion Medicine and Cell Therapy, Tokushima University Hospital, Tokushima, Japan
  5. 5Department of Rehabilitation Medicine, Tokushima University Hospital, Tokushima, Japan
  1. Correspondence to Shin Kondo, Division of Rehabilitation, Tokushima University Hospital, Tokushima, Tokushima, Japan; skondo{at}tokushima-u.ac.jp

Abstract

Objectives Muscle strength decline is reported to predict mortality in many cancers. However, there is little knowledge of the relation between muscle strength decline and clinical outcomes of allogeneic haematopoietic stem cell transplantation (allo-HSCT). This study aimed to determine the impact of pre-transplant lower extremity muscle strength (LEMS) on post-transplant overall survival (OS) and non-relapse mortality (NRM).

Methods In this retrospective cohort study, 97 adult patients underwent allo-HSCT during 2012–2020. LEMS was defined as knee extension force divided by patient’s body weight. The patients were divided into low and high LEMS groups based on pre-transplant LEMS. OS was measured using the Kaplan-Meier method and the Cox proportional hazards model. The cumulative incidence of NRM was evaluated using the Fine and Gray method, with relapse considered as a competing risk event.

Results Probability of OS was significantly lower in the low LEMS groups (HR 2.48, 95% CI 1.20 to 5.12, p=0.014) than in the high LEMS group on multivariate analysis. Five-year OS was 25.8% and 66.4% in the low and high LEMS groups, respectively. Risk of NRM was significantly higher in the low LEMS group (HR 4.49, 95% CI 1.28 to 15.68, p=0.019) than in the high LEMS group. The cumulative incidence of NRM was 41.4% and 11.1% in the low and high LEMS groups, respectively.

Conclusions Pre-transplant LEMS was a significant factor in predicting OS and NRM.

  • leukaemia
  • lymphoma
  • haematological disease
  • prognosis
  • rehabilitation
  • supportive care

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

https://doi.org/10.1136/bmjspcare-2021-003256

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplementary information.

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    Footnotes

    • Contributors S Kondo and TS designed, analysed, interpreted the data and wrote the manuscript. KK, MO, KS, TH, SF, SN, HM, NS, RO, MA and S Katoh contributed with data collection and commented on the manuscript. All authors read and approved the final manuscript.S Kondo is responsible for the overall content and accepts full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision to publish.

    • 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 None declared.

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