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Prognostic impact of skeletal muscle assessed by computed tomography in patients with acute myeloid leukemia

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Abstract

Skeletal muscle atrophy and loss of adipose tissue, referred to as sarcopenia and adipopenia, respectively, are often observed in cancer patients. We investigated the impact of sarcopenia and adipopenia on clinical outcomes in 90 adult patients with newly diagnosed acute myeloid leukemia (AML) who received induction chemotherapy. Computed tomography (CT) before treatment revealed sarcopenia in 39 patients (43%) and adipopenia in 35 patients (39%). We analyzed the treatment efficacy of induction chemotherapy and survival outcomes. Three-year overall survival (OS) was 35% in the sarcopenic group and 67% in the non-sarcopenic group (P < 0.001). Three-year OS was 33% in the adipopenic group and 67% in the non-adipopenic group (P < 0.005). Multivariate analysis showed an association between sarcopenia and lower OS (hazard ratio, 2.27; 95% confidence interval, 1.11–4.79; P < 0.05), with other prognostic factors of performance status > 2 (P < 0.05) and adverse cytogenetic risk (P < 0.05). In elderly patients over 60 years old, 3-year OS was 0% for the sarcopenic group and 49% for the non-sarcopenic group (P < 0.0005). These results indicate the prognostic values of sarcopenia in adult patients with AML.

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Acknowledgements

H.T. and M.S. designed this research. N.N., S.N., T.M., and J.K. performed the research. M.S. and T.H. analyzed the data. S.N., N.N., and H.T. wrote the paper.

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Authors and Affiliations

  1. First Department of Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan

    Nobuhiko Nakamura, Soranobu Ninomiya, Takuro Matsumoto, Hiroshi Nakamura, Junichi Kitagawa, Makoto Shiraki, Takeshi Hara, Masahito Shimizu & Hisashi Tsurumi

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  1. Nobuhiko Nakamura
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  2. Soranobu Ninomiya
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  3. Takuro Matsumoto
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  4. Hiroshi Nakamura
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  7. Takeshi Hara
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  9. Hisashi Tsurumi
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Correspondence to Soranobu Ninomiya.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendment or comparable ethical standards.

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Nakamura, N., Ninomiya, S., Matsumoto, T. et al. Prognostic impact of skeletal muscle assessed by computed tomography in patients with acute myeloid leukemia. Ann Hematol 98, 351–359 (2019). https://doi.org/10.1007/s00277-018-3508-1

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  • DOI: https://doi.org/10.1007/s00277-018-3508-1

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