Skeletal muscle mass during chemotherapy for haematological malignancies : a retrospective study

Objective:
This study investigated whether baseline or alteration in muscle mass affects complications during chemotherapy or overall survival (OS) in hematological malignancies.
Methods:
Skeletal muscle index (SMI) was evaluated by bioimpedance analysis before and after chemotherapy in patients with hematological malignancies, and the association between muscle mass and clinical data was retrospectively analyzed.
Results:
Exactly 104 patients were enrolled, with a mean age of 62.2 years. SMI was 7.85 and 6.08 in male and female patients under 65 years and 7.10 and 5.92 over 65 years, before chemotherapy, respectively. Lower baseline SMI was not correlated with worse OS in total patients (p=0.915). After a median measurement interval of 30 days after chemotherapy (n=67), body weight and SMI decreased by 2.73% and 2.87% (mean), respectively. The decrease in body weight correlated with the loss of trunk muscle mass (R2=0.2107) but was more strongly associated with the loss of lower limbs muscle mass (R2=0.3985). The muscle mass of lower limbs significantly decreased in lymphoma patients who experienced febrile neutropenia (-0.42% vs -6.04%, p=0.040). OS significantly decreased in lymphoma patients with loss of lower limbs muscle ≥2.8% (p=0.0327).
Conclusions:
Muscle loss occurred following anti-cancer treatments, significantly contributing to worse outcomes. Body composition assessment and relevant multi-modal prevention of muscle loss may be vital for patients receiving chemotherapy for hematological malignancies.

This article has been accepted for publication in BMJ Supportive & Palliative Care, 2024 following peer review, and the Version of Record can be accessed online at https://doi.org/10.1136/spcare-2024-004870.