Abnormal body composition is a predictor of adverse outcomes after autologous haematopoietic cell transplantation.
Haematopoietic cell transplantation
Lymphoma
Mortality
Obesity
Sarcopenia
complications
Journal
Journal of cachexia, sarcopenia and muscle
ISSN: 2190-6009
Titre abrégé: J Cachexia Sarcopenia Muscle
Pays: Germany
ID NLM: 101552883
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
27
11
2019
revised:
27
01
2020
accepted:
25
02
2020
pubmed:
27
3
2020
medline:
26
8
2021
entrez:
27
3
2020
Statut:
ppublish
Résumé
The number of patients undergoing autologous haematopoietic cell transplant (HCT) is growing, but little is known about the factors that predict adverse outcomes. Low muscle mass and obesity are associated with disability and premature mortality in individuals with non-malignant diseases and may predict outcomes after autologous HCT. This was a retrospective cohort study of 320 patients who underwent autologous HCT for Hodgkin or non-Hodgkin lymphoma between 2009 and 2014. Sarcopenia {skeletal muscle index male: <43 cm/m Median age at HCT was 53.3 years (range, 18.5 to 78.1 years); 26.3% were sarcopenic and an additional 7.8% were sarcopenic obese pre-HCT. Sarcopenic obesity was associated with increased risk of prolonged hospitalization [odds ratio (OR) = 3.6, 95% confidence interval (CI) 1.3-9.8], intensive care unit admission (OR = 4.7, 95% CI 1.5-16.1), and unplanned readmission after HCT (OR = 13.6, 95% CI 2.5-62.8). Patients who were sarcopenic obese also had the highest mortality risk at 1 year [hazard ratio (HR): 3.9, 95% CI 1.1-11.0] and 5 years (HR: 2.5, 95% CI 1.1-5.5), compared with patients with normal body composition. Sarcopenia alone, but not obesity alone, was associated with an increased risk of these outcomes, albeit with a lower magnitude of risk than in patients who were sarcopenic obese. Sarcopenic obesity was an important predictor of outcomes in patients undergoing autologous HCT. These findings could inform targeted prevention strategies in patients at highest risk of complications after HCT.
Sections du résumé
BACKGROUND
The number of patients undergoing autologous haematopoietic cell transplant (HCT) is growing, but little is known about the factors that predict adverse outcomes. Low muscle mass and obesity are associated with disability and premature mortality in individuals with non-malignant diseases and may predict outcomes after autologous HCT.
METHODS
This was a retrospective cohort study of 320 patients who underwent autologous HCT for Hodgkin or non-Hodgkin lymphoma between 2009 and 2014. Sarcopenia {skeletal muscle index male: <43 cm/m
RESULTS
Median age at HCT was 53.3 years (range, 18.5 to 78.1 years); 26.3% were sarcopenic and an additional 7.8% were sarcopenic obese pre-HCT. Sarcopenic obesity was associated with increased risk of prolonged hospitalization [odds ratio (OR) = 3.6, 95% confidence interval (CI) 1.3-9.8], intensive care unit admission (OR = 4.7, 95% CI 1.5-16.1), and unplanned readmission after HCT (OR = 13.6, 95% CI 2.5-62.8). Patients who were sarcopenic obese also had the highest mortality risk at 1 year [hazard ratio (HR): 3.9, 95% CI 1.1-11.0] and 5 years (HR: 2.5, 95% CI 1.1-5.5), compared with patients with normal body composition. Sarcopenia alone, but not obesity alone, was associated with an increased risk of these outcomes, albeit with a lower magnitude of risk than in patients who were sarcopenic obese.
CONCLUSIONS
Sarcopenic obesity was an important predictor of outcomes in patients undergoing autologous HCT. These findings could inform targeted prevention strategies in patients at highest risk of complications after HCT.
Identifiants
pubmed: 32212263
doi: 10.1002/jcsm.12570
pmc: PMC7432567
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
962-972Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Informations de copyright
© 2020 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders.
Références
Aging Male. 2013 Jun;16(2):33-7
pubmed: 23517433
Biol Blood Marrow Transplant. 2018 Aug;24(8):1741-1747
pubmed: 29496561
Am J Respir Crit Care Med. 2004 Oct 15;170(8):870-8
pubmed: 15271690
Clin Cases Miner Bone Metab. 2013 Jan;10(1):11-4
pubmed: 23858303
Lancet. 2019 Jun 29;393(10191):2636-2646
pubmed: 31171417
Bone Marrow Transplant. 2014 Oct;49(10):1323-9
pubmed: 25068419
Bone Marrow Transplant. 2016 Oct;51(10):1283-1300
pubmed: 27272454
J Frailty Aging. 2016;5(4):194-200
pubmed: 27883164
Ann Oncol. 2018 Feb 1;29(suppl_2):ii1-ii9
pubmed: 29506228
Lancet Oncol. 2008 Jul;9(7):629-35
pubmed: 18539529
J Natl Cancer Inst. 2019 Aug 1;111(8):837-844
pubmed: 30951603
Biol Blood Marrow Transplant. 2017 Oct;23(10):1646-1650
pubmed: 28669923
JAMA Oncol. 2016 Jun 01;2(6):782-9
pubmed: 26891703
Am J Hematol. 2017 Sep;92(9):E529-E533
pubmed: 28612451
Appl Physiol Nutr Metab. 2008 Oct;33(5):997-1006
pubmed: 18923576
J Cachexia Sarcopenia Muscle. 2019 Oct;10(5):1143-1145
pubmed: 31661195
Biol Blood Marrow Transplant. 2014 Mar;20(3):402-408.e1
pubmed: 24342394
Bone Marrow Transplant. 2019 Jul;54(7):943-960
pubmed: 30390059
Cancer. 2018 Feb 15;124(4):816-825
pubmed: 29125192
J Hepatol. 2015 Jul;63(1):131-40
pubmed: 25724366
Clin Cancer Res. 2014 Feb 1;20(3):754-63
pubmed: 24218510
J Clin Oncol. 2003 Nov 1;21(21):3918-27
pubmed: 14517188
J Clin Oncol. 2014 Oct 10;32(29):3249-56
pubmed: 25154831
Clin Res Hepatol Gastroenterol. 2018 Jun;42(3):205-215
pubmed: 29162460
Leukemia. 2013 Apr;27(5):1139-45
pubmed: 23183426
Leuk Lymphoma. 2015;56(10):2855-62
pubmed: 25739940
J Clin Oncol. 2013 Apr 20;31(12):1539-47
pubmed: 23530101
J Nucl Med. 2017 Jul;58(7):1155-1161
pubmed: 28302761
J Appl Physiol (1985). 2004 Dec;97(6):2333-8
pubmed: 15310748
Br J Haematol. 2016 Nov;175(3):440-447
pubmed: 27377168
Cancer. 2017 Dec 15;123(24):4868-4877
pubmed: 28881381
N Engl J Med. 1995 Dec 7;333(23):1540-5
pubmed: 7477169
J Acquir Immune Defic Syndr. 2004 Dec 1;37 Suppl 5:S262-76
pubmed: 15722869
J Cachexia Sarcopenia Muscle. 2020 Aug;11(4):962-972
pubmed: 32212263
Curr Opin Support Palliat Care. 2009 Dec;3(4):269-75
pubmed: 19667996
J Cachexia Sarcopenia Muscle. 2017 Apr;8(2):285-297
pubmed: 27897414
J Clin Endocrinol Metab. 2004 Oct;89(10):5124-31
pubmed: 15472216
Biol Blood Marrow Transplant. 2013 Oct;19(10):1498-501
pubmed: 23906634
Biol Blood Marrow Transplant. 2016 Jul;22(7):1234-1241
pubmed: 27095691
Clin Transplant. 2019 Jan;33(1):e13450
pubmed: 30462375
Clin Transplant. 2016 Mar;30(3):289-94
pubmed: 26717257
JAMA Oncol. 2017 Dec 1;3(12):e172319
pubmed: 28796857
Obesity (Silver Spring). 2007 Feb;15(2):370-6
pubmed: 17299110
Biol Blood Marrow Transplant. 2013 Jul;19(7):1116-23
pubmed: 23660172
Interact Cardiovasc Thorac Surg. 2016 Sep;23(3):486-97
pubmed: 27226400
Transplantation. 2020 Jan;104(1):97-103
pubmed: 31205265