Sarcopenia and low muscle radiodensity associate with impaired FEV<sub>1</sub> in allogeneic haematopoietic stem cell transplant recipients
Notice bibliographique
Résumé
Abstract Background Quantification of skeletal muscle using computed tomography (CT) is accessible using cancer patients' standard oncologic images. Reduced muscle mass may be related to reduced respiratory muscle strength; however, the impact of this on lung functional parameters is not characterized in adult allogeneic haematopoietic stem cell transplant (alloHCT) recipients. Methods A consecutive retrospective series ( n = 296) of patients who had alloHCT at a comprehensive cancer centre between March 2005 and April 2015 were included. Pre‐transplant CT scans were used to quantify skeletal muscle and adipose tissue at the fourth thoracic (T4) and/or third lumbar (L3) level. Tumour and patient characteristics were recorded, including forced expiratory volume in 1 second (FEV 1 ) by spirometry. Regression models were created to characterize predictive relationships. Results A total of 296 patients (♂ n = 161; ♀ n = 135) were included, all of whom had chest CT as part of standard care; a subset of these ( n = 215, 72.6%) also had abdominal CT. Diagnoses were non‐Hodgkins lymphoma ( n = 165), acute myeloid leukaemia ( n = 66), Hodgkin's disease ( n = 14), acute lymphocytic leukaemia ( n = 14), myelodysplastic syndromes ( n = 18), and other ( n = 19). In multivariable linear regression adjusted for sex ( P < 0.0001), age ( P < 0.0001), haematopoietic cell transplantation‐specific co‐morbidity index ( P = 0.010), and parameters of pulmonary function testing (defined by spirometry, P < 0.0001), both T4 muscle index [ β 0.127 (95% confidence interval 0.019; 0.252), P < 0.0001] and T4 muscle radiodensity [ β 0.132 (95% confidence interval 0.087; 0.505), P = 0.006] were independently associated with FEV 1 ; disease risk index ( P = 0.877) and Karnofsky performance status ( P = 0.548) were not associated with FEV 1 . Similar conclusions were obtained when L3 muscle index and radiodensity were considered. Unlike T4, L3 muscle index values can be compared with published cut‐off values for sarcopenia. Overall rates of sarcopenia were uniformly higher in the HCT population than in age‐matched and sex‐matched patients with solid tumours [alloHCT ♂64.7% vs. solid tumour ♂56.6% ( P < 0.001); alloHCT ♀57.6% vs. solid tumour ♀36.0% ( P < 0.001)]. Significant but moderate correlations ( P < 0.001) were found for muscle area and radiodensity between L3 and T4, for both men and women; adipose tissue quantity also correlated significantly ( P < 0.001) between L3 and T4 for both men and women. Conclusions Lumbar or thoracic CT images are useful for body composition assessment in this population and reveal high rates of sarcopenia, similar to those reported in very elderly patients. Reduced muscle mass and radiodensity associate with impaired FEV 1 even after adjustment for clinical covariables including co‐morbidities, performance status, disease risk, and mild intrinsic pulmonary disease (chronic obstructive pulmonary disease) defined by spirometry.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».