Sarcopenia among patients after allogeneic hematopoietic stem cell transplantation and the impact of chronic graft versus host disease

Ljubas Kelečić, Dina; Lelas, Antonela; Karas, Irena; Desnica, Lana; Vukić, Tamara; Sabol, Ivan; Vranešić Bender, Darija; Serventi Seiwerth, Ranka; Perić, Zinaida; Duraković, Nadira; Vitali Čepo, Dubravka; Vrhovac, Radovan; Nemet, Damir; Pavletic, Steven; Pulanić, Dražen; Krznarić, Željko (2020) Sarcopenia among patients after allogeneic hematopoietic stem cell transplantation and the impact of chronic graft versus host disease. Journal of Cancer Research and Clinical Oncology . ISSN 0171-5216

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Official URL: https://link.springer.com/article/10.1007%2Fs00432...

Abstract

Purpose This study investigated the frequency and characteristics of sarcopenia among patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT) with a specific focus on the chronic graft-versus-host disease (cGVHD) population and its association with malnutrition, vitamin D and clinical characteristics. Methods We assessed sarcopenia, vitamin D levels, and nutritional status in 73 patients who underwent allo-HSCT, of which 45 were diagnosed with cGVHD. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People (EWGSOP) criteria. Results Sarcopenia was diagnosed in 19.2% of patients after allo-HSCT with statistically no significant difference between cGVHD and non- cGVHD patients. The risk factor for sarcopenia was the male gender. Sarcopenia in allo-HSCT patients correlated strongly with malnutrition and with current corticosteroid treatment (p < 0.005). Among cGVHD patients sarcopenia additionally correlated strongly with the number of prior systemic immunosuppressive therapy lines (p < 0.005) and moderately with the intensity of immunosuppression, cGVHD severity global rating assessed by both the health care provider and the patient and joint and fascia cGVHD involvement (p < 0.05). Vitamin D deficiency was found in more than 54.8% of patients, but the correlation to sarcopenia was not found. Conclusion Sarcopenia was found to be common in long term survivors of allo-HSCT independently of the cGVHD diagnosis. Prospective longitudinal studies are needed for a better understanding of factors affecting the development of sarcopenia after allo-HSCT.

Item Type:

Article

Additional Information:

This work was supported, in part, by the Unity Through Knowledge Fund project entitled "Clinical and biological factors determining severity and activity of chronic Graft-versus-Host disease after allogeneic hematopoietic stem cell transplantation", and also, in part, by the Croatian Science Foundation project IP-2016-06-8046 entitled "New biomarkers for chronic graft-versus-host disease". We would also like to thank the many members of the multidisciplinary team for cGVHD at the University Hospital Center Zagreb, Croatia.

Uncontrolled Keywords:

Sarcopenia ; Allo-HSCT ; cGVHD ; Malnutrition ; Hand-grip strength ; Vitamin D

Subjects:

BIOMEDICINE AND HEALTHCARE > Clinical Medical Sciences > Oncology
BIOMEDICINE AND HEALTHCARE > Pharmacy

Divisions:

Division of Molecular Medicine

Projects: