The impact of sarcopenia on transplant-related complications and number of days spent in the hospital in patients with lymphoma.

Abstract

7044 Background: Sarcopenia, a state of abnormally low muscle mass, has been found to be associated with more treatment-related complications and shorter overall survival in patients with different cancers. Sarcopenia can be reliably assessed with routine computerized tomography (CT). The objectives of the study were to determine whether sarcopenia is associated with the number of complications and the number of days spent in the hospital in patients undergoing autologous hematopoietic stem cell transplantation (autoSCT) for lymphoma. Methods: Adult patients treated for non-Hodgkin's or Hodgkin's lymphoma with autoSCT between 2/2005 – 6/2/2012 at the University of Michigan (U-M) Bone Marrow Transplant (BMT) Program were eligible for inclusion if a CT of the abdomen was performed within 60 days prior to autoSCT. Total psoas area and lean psoas area were calculated for each patient with cross-sectional area and density measurements taken at the level of the fourth lumbar vertebra using algorithms programmed in the Analytic Morphomics Lab at U-M. All analyses were completed using Poisson regression models controlling for age, gender, body mass index, Hematopoeitic-Cell Transplant Co-morbidity Index (HCT-CI), and Karnofsky performance status (KPS). Results: Total and lean psoas area were calculated in the 121 patients who met inclusion criteria. Men with greater psoas muscle measures experienced fewer complications and spent fewer days in the hospital during the autoSCT admission compared to men who were sarcopenic (complications β = -0.206, p=0.001; hospital treatment days β = -0.043, p=0.029). Sarcopenia did not play a role in outcomes in women. A strong association existed between sarcopenia and re-admission days within 100 days following autoSCT among both men (β = -1.183, p<0.0001) and women (β = -0.805, p<0.0001). Conclusions: Muscle mass is independently associated with complication rates and duration of hospitalization in patients undergoing autoSCT for lymphoma. CT-determined psoas muscle mass may be a valuable addition to other indices used to guide optimal treatment selection and serve as a potentially modifiable host factor to improve transplant-related outcomes.