scholarly journals Gender differences in physical function and muscle mass change in patients undergoing allogeneic hematopoietic stem cell transplantation

2017 ◽  
Vol 52 (10) ◽  
pp. 1460-1462 ◽  
Author(s):  
T Takekiyo ◽  
K Dozono ◽  
S Nara ◽  
Y Murayama ◽  
N Minamihama ◽  
...  
Keyword(s):  
Gender Differences ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Physical Function ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Muscle Mass ◽  
Mass Change ◽  
Hematopoietic Stem

Relationship of physical function to outcomes in autologous hematopoietic stem cell transplantation.

2019 ◽  
Vol 37 (31_suppl) ◽  
pp. 116-116 ◽  
Author(s):  
Joseph Caveney ◽  
Abraham Sebastian Kanate ◽  
Gerald Hobbs ◽  
Anne Swisher
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Physical Function ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Hematopoietic Stem ◽  
Platelet Recovery ◽  
Neutrophil Recovery ◽  
Hospital Days

116 Background: Physical function is an important consideration for autologous hematopoietic stem cell transplantation (auto-HSCT) but it is often judged subjectively rather than tested. This study examined the ability of functional test results to predict key transplant outcomes versus subjective rating. Methods: Patients receiving outpatient auto-HSCT performed a pre-transplant 2-minute walk test (2MWT), isometric handgrip testing, 5-times sit-to-stand test (5XSST) and timed up and go test (TUG). Karnofsky Performance Status (KPS) score was assigned by the treating oncologist. At day 100 following auto-HSCT, charts were extracted for age, gender, diagnosis, total number of hospital days, and days of platelet and neutrophil recovery. Predictions were determined through stepwise regression analysis. Results: Data from 37 patients (24 M, 13 F) were analyzed. The most common diagnosis was multiple myeloma. One patient expired prior to day 100. KPS was weakly correlated with all functional tests (spearman rho values 0.15 to 0.27, p values 0.07 to 0.32). KPS did not predict # hospital days (p = 0.53), neurophil recovery (p = 0.22) or platelet recovery (p = 0.51). In contrast, there was a trend for 5XSTS to predict # hospital days (p = 0.10), although predictive ability was low (R2 = 0.07). TUG was the best predictor of platelet recovery (p = .021), followed by 2MWT (p = 0.23) (R2 = 0.10). KPS did not predict any outcome measure, and none of the variables predicted neutrophil recovery. Conclusions: KPS does not correlate well with physical function testing nor does it predict key auto-HSCT short-term outcomes. While not a major contributor to hospitalization days or blood count recovery time, 5XSST and TUG appear to have potential to predict transplant outcomes. Future testing with larger samples is needed to determine the impact of physical function on long-term auto-HSCT outcomes.

scholarly journals Association of Sarcopenia with Toxicities and Survival after Autologous Hematopoietic Stem Cell Transplantation for Adults with Lymphomas

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 2158-2158 ◽  
Author(s):  
Abel Costa Neto ◽  
Bruna Del Guerra Carvalho Moraes ◽  
Ilanna Marques Gomes Rocha ◽  
Felipe Acquesta Bezerra ◽  
Galtieri Otavio Cunha Medeiros ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Muscle Mass ◽  
Conditioning Regimen ◽  
Hematopoietic Stem ◽  
Icu Admission

Abstract Introduction: Sarcopenia, defined as low muscle mass and low muscle function and/or reduced physical performance, has been identified as a potential risk factor for adverse outcomes in a variety of conditions like elderly patients and patients with solid tumors. However, fewer studies assessed this association in patients undergoing autologous hematopoietic stem cell transplantation (autoHSCT). With this aim, we performed a retrospective study to evaluate the effect of sarcopenia on complications (such as toxicities, infections and intensive care unit - ICU - admission) and survival after autoHSCT for adults with lymphoma. Methods: We enrolled 135 patients with lymphoma who underwent autoHSCT between January, 2014 and December, 2017, in a single center. Computed tomography (CT) imaging scans were used for muscle mass analysis. Skeletal muscle area (SMA, cm2) was measured on axial CT images at the level of the third lumbar vertebra (L3) using appropriate software (Slice O´Matic, Tomovision, CA). SMA was normalized for height to obtain the skeletal muscle index (SMI, cm2/m2). We set our own cut-off values at lowest specific tertiles of SMI based on sex and body mass index (BMI, Kg/m2) for diagnosing sarcopenia. Sarcopenia was defined in this cohort as SMI <46 cm²/m² if BMI <25 kg/m² or <51 cm²/m² if BMI ≥25 kg/m² in men, and ≤41.5 cm²/m² in women. Toxicities (overall, renal, hepatic and gastrointestinal) after autoHSCT were graded according to the National Cancer Institute Common Toxicity Criteria (version 4.0). In addition, infections and ICU admission were also analyzed. Patients with previous autoHSCT CT scans more than 120 days were excluded. Probabilities of overall survival (OS), event-free survival (EFS) and treatment-related mortality (TRM) were calculated according to the Kaplan-Meier method. Unadjusted and adjusted analyses were conducted by using Logistic Regression models to determine the association of covariates with outcome. The significance level was adopted at p<0.05. Results: A total of 110 patients met the eligibility criteria (39 sarcopenic and 71 non-sarcopenic). Mean age at transplant was similar in both groups (43 years, p=0.96), with 18% of elderly. The majority of patients was male (65%) and had an aggressive disease at diagnosis (77%). Sarcopenics had a higher Charlson comorbidity index (≥3) at transplant than non-sarcopenics (p=0.02). The conditioning regimen used was different between groups, with a higher proportion of bussulfan-based conditioning in the sarcopenic group (p=0.04). Table 1 list characteristics between sarcopenics and non-sarcopenics patients. Neutrophil recovery was achieved at a median time of 11 days after transplant in both groups (p=0.55). We found association between grade 3-4 gastrointestinal toxicity and sarcopenia (44% vs. 24%; OR 2.46, CI95% 1.07-5.66, p=0.03), although, after adjustment by conditioning regimen, no significant difference was detected (OR 2.09, CI95% 0.89-4.97, p=0.10). No statistically differences were detected in ICU admission, occurrence of infection, hepatic, renal or overall toxicities. Median follow-up of survivors was 20 months (range, 1-50). The 2-years OS and EFS were 72% (CI95% 61-81; sarcopenic 70% [50-84] vs. non-sarcopenic 74% [59-84], p=0.99) and 62% (CI95% 51-71; sarcopenic 68% [49-81] vs. non-sarcopenic 59% [46-70], p=0.37), respectively. The cumulative incidence of TRM was 6.5% at day 100 (CI95% 2.5-11.9; sarcopenic 5.1% [1.3-19.0] vs. non-sarcopenic 5.7% [2.2-14.5], p=0.70). Conclusion: In our study, sarcopenia was not statistically associated with severe toxicity and higher mortality. To the best of our knowledge, this is the first study to assess CT images and compare sarcopenia with toxicity in aHSCT for lymphoma. Prospective studies are needed to investigate the real impact of sarcopenia on outcomes after autologous transplantation. Disclosures No relevant conflicts of interest to declare.

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