Risks of Muscle Atrophy in Patients with Malignant Lymphoma after Autologous Stem Cell Transplantation.

Physical therapy research Pub Date : 2020-11-13 eCollection Date: 2021-01-01 DOI:10.1298/ptr.E10041
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
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引用次数: 2

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.

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自体干细胞移植后恶性淋巴瘤患者肌肉萎缩的风险。
目的:恶性淋巴瘤(ML)患者的肌肉萎缩与自体干细胞移植(ASCT)相关的预后相关。然而,ASCT对ML患者肌肉质量的影响尚不清楚。本研究的目的是调查ASCT后肌肉质量的变化和肌肉萎缩的风险特征。方法:入选40例难治性ML患者,年龄58[20-74]岁,女/男16/24,体重指数(BMI) 21.1 kg/m2[17.1-29.6]。采用腰肌指数(PMI)评估ASCT前后腰肌质量。使用的统计分析:分别用决策树分析评估与PMI变化率严重下降相关的独立因素。结果:ASCT后PMI显著降低(4.61 vs 4.55 cm2/m2;P = 0.0425)。根据决策树分析,选择该方案作为初始分割方案。MCEC组PMI变化率为-5.57%,LEED组PMI变化率为-3.97%。在接受LEED治疗的患者中,第二个分支因素是BMI。BMI < 20.3 kg/m2的患者,PMI变化率为-7.16%。BMI≥20.3 kg/m2的患者,PMI变化率为4.05%。结论:我们证明了ML患者ASCT后肌肉质量下降,接受MCEC的患者和低BMI的患者有肌肉质量下降的风险。
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