Changes in skeletal muscle function during chemotherapy and related factors in patients with acute leukemia

Abstract

Introduction: Skeletal muscle function is an important prognostically relevant indicator in patients with acute leukemia (AL), but skeletal dysfunction during chemotherapy is not well understood. This study aimed to investigate the factors that influence changes in skeletal muscle function from before the start of chemotherapy to before allogeneic hematopoietic stem cell transplantation (allo-HSCT).

Methods: This was a retrospective cohort study that included 90 patients with AL who underwent chemotherapy before transplantation to perform allo-HSCT (men, 67.3%; median age, 53 years). The outcome measure was defined as changes in skeletal muscle function from before chemotherapy to before allo-HSCT, and was assessed by measuring the psoas muscle index (PMI) as skeletal muscle quantity and computed tomography values (CTV) as skeletal muscle quality using a computed tomography scanner. We examined the differences in PMI and CTV before chemotherapy and allo-HSCT, and the factors associated with changes in PMI.

Result: The mean PMI for before chemotherapy and allo-HSCT were 4.6 ± 1.4 cm²/m² and 4.0 ± 1.3 cm²/m² and significant differences were observed (p < 0.001). However, the mean CTV before chemotherapy and allo-HSCT were 47.3 ± 4.5 HU and 47.4 ± 5.0 HU, respectively, and no significant differences were found (p = 0.798). In stepwise multiple regression analysis, age and sex were identified as factors related to changes in PMI (age, p = 0.019; sex, p = 0.001).

Conclusion: We found that skeletal muscle quantity decreased during chemotherapy in patients with AL and was influenced by male sex and older age.

Trial registration number: TRIAL REGISTRATION NUMBER: 34-096(11,243). Date of registration: September 11, 2023.

Keywords: Acute leukemia; Skeletal muscle quantity; chemotherapy.