Yasunobu Takeoka1, Kazuki Sakatoku2, Akiko Miura2, Ryosuke Yamamura2, Taku Araki2, Hirotaka Seura3, Terue Okamura3, Hideo Koh4, Hirohisa Nakamae4, Masayuki Hino4, Kensuke Ohta2. 1. Department of Hematology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan; Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan. Electronic address: takeoka7@gmail.com. 2. Department of Hematology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan. 3. Department of PET Center, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan. 4. Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
Abstract
BACKGROUND: Increasing evidence suggests that decreased skeletal muscle mass (sarcopenia) or adipose tissue assessed using computed tomography (CT) predicts negative outcomes in patients with solid tumors. However, the prognostic value of such an assessment in multiple myeloma (MM) remains unknown. PATIENTS AND METHODS: Consecutive patients with newly diagnosed symptomatic MM were retrospectively analyzed. The cross-sectional area of skeletal muscles and subcutaneous or visceral adipose tissue was measured using CT. Body composition indexes (skeletal muscle index, subcutaneous adipose tissue index [SAI], and visceral adipose tissue index) were calculated. The association between these indexes and overall survival (OS) was examined. RESULTS: Of 56 evaluable patients, 37 (66%) had sarcopenia. The 2-year OS in patients with SAI < median was 58% compared with 91% in those with SAI ≥ median (P = .006). In multivariate analyses, SAI < median was significantly associated with poor OS (hazard ratio, 4.05; P = .02). Sarcopenia was not associated with OS. The maximum value of the standardized uptake value was significantly higher in patients with SAI < median (P = .02). CONCLUSION: The findings of this study suggest that low subcutaneous adipose tissue at baseline predicts poor survival outcome in patients with MM.
BACKGROUND: Increasing evidence suggests that decreased skeletal muscle mass (sarcopenia) or adipose tissue assessed using computed tomography (CT) predicts negative outcomes in patients with solid tumors. However, the prognostic value of such an assessment in multiple myeloma (MM) remains unknown. PATIENTS AND METHODS: Consecutive patients with newly diagnosed symptomatic MM were retrospectively analyzed. The cross-sectional area of skeletal muscles and subcutaneous or visceral adipose tissue was measured using CT. Body composition indexes (skeletal muscle index, subcutaneous adipose tissue index [SAI], and visceral adipose tissue index) were calculated. The association between these indexes and overall survival (OS) was examined. RESULTS: Of 56 evaluable patients, 37 (66%) had sarcopenia. The 2-year OS in patients with SAI < median was 58% compared with 91% in those with SAI ≥ median (P = .006). In multivariate analyses, SAI < median was significantly associated with poor OS (hazard ratio, 4.05; P = .02). Sarcopenia was not associated with OS. The maximum value of the standardized uptake value was significantly higher in patients with SAI < median (P = .02). CONCLUSION: The findings of this study suggest that low subcutaneous adipose tissue at baseline predicts poor survival outcome in patients with MM.
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