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Prognostic value of sarcopenia in survivors of hematological malignances undergoing a hematopoietic stem cell transplantation: a systematic review and meta-analysis

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Abstract

Purpose

Sarcopenia is increasingly recognized as an independent risk factor for poor outcomes in patients undergoing hematopoietic stem cell transplantation (HSCT), and it is a potentially modifiable factor. The purpose of the present systematic review and meta-analysis is to summarize and integrate current evidence in this field.

Methods

We searched EMBASE, MEDLINE, and Cochrane DSR through Ovid and PubMed websites to identify relevant studies. Studies evaluated sarcopenia before HSCT and reported associations between sarcopenia and post-transplant outcomes were included. Two authors independently applied eligibility criteria, assessed quality, and extracted data. Odds ratio (OR) and their 95% confidence intervals (CIs) were pooled to examine the association between sarcopenia and post-transplant outcomes by using the review manager 5.3 software.

Results

Seven retrospective cohort studies met our inclusion criteria. The overall quality of studies was low to moderate. Sarcopenia was associated with higher non-relapse mortality [odds ratio (OR) 1.97; 95% CI 1.45, 2.68; P < 0.0001; I2 = 0%] and shorter overall survival [odds ratio (OR) 0.44; 95% CI 0.26, 0.75; P = 0.002; I2 = 65%] in patients undergoing HSCT.

Conclusions

Clinicians could use sarcopenia to balance the risks and benefits of transplantation as early as possible; in addition, interventions can be used to prevent sarcopenia and improve physical function and quality of life. Well-designed, prospective, and large-scale clinical studies are needed to consolidate the evidence.

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Authors and Affiliations

  1. Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China

    Shuli Jia, Runjuan Qiao, Yuting Xiao, Wanyu Zhao, Yunli Zhao, Xiaolei Liu & Birong Dong

  2. National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041, Sichuan, China

    Shuli Jia, Runjuan Qiao, Yuting Xiao, Dan Qin, Wanyu Zhao, Yunli Zhao, Xiaolei Liu & Birong Dong

  3. Chengdu Medical College, Chengdu, Sichuan, China

    Dan Qin

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  1. Shuli Jia
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Contributions

Idea and protocol writing were performed by Birong Dong and Shuli Jia. Literature search, data collection, and analysis were performed by Shuli Jia, Runjuan Qiao, Yuting Xiao, and Dan Qin. Methodology: Birong Dong, Shuli Jia, Wanyu Zhao, and Yunli Zhao. The first draft of the manuscript was written by Shuli Jia, and all authors commented on previous versions of the manuscript. The revised draft of the manuscript was written by Shuli Jia and Xiaolei Liu. All authors read and approved the final manuscript.

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Correspondence to Birong Dong.

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Appendix 1

Appendix 1

Medline (via ovid) search strategy

  1. 1.

    exp. Sarcopenia/ or exp. Muscular Atrophy/

  2. 2.

    (“Muscular Atrophy” or Sarcopenia or Sarcopenias or Sarcopenic or presarcopenia or Sarcopenia or “low muscle mass” or “ low muscle function” or “ muscle weakness” or “muscle loss”).af.

  3. 3.

    1 or 2

  4. 4.

    exp. Hematologic Neoplasms/

  5. 5.

    (Hematolog* or hamatolog*).mp.

  6. 6.

    (carcin* or cancer* or neoplas* or tumour* or tumor* or malig*).mp.

  7. 7.

    3 and 4

  8. 8.

    (leukenia or lymphoma or “myelodysplastic syndromes” or MDS or myeloma).af.

  9. 9.

    4 or 6 or 7

  10. 10.

    exp. Hematopoietic Stem Cell Transplantation/ or exp. Bone Marrow Transplantation/ or exp. Peripheral Blood Stem Cell Transplantation/

  11. 11.

    (“Bone Marrow Cell” or “Bone Marrow” or “Peripheral Stem Cell” or “ Peripheral Blood Stem Cell” or “hematopoietic Stem Cell” or “hamatopoietic Stem Cell” or stem cell*).af.

  12. 12.

    Transpl*.af

  13. 13.

    10 and 11

  14. 14.

    (HCT or HSCT).af.

  15. 15.

    9 or 12 or 13

  16. 16.

    3 and 8 and 14

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Jia, S., Qiao, R., Xiao, Y. et al. Prognostic value of sarcopenia in survivors of hematological malignances undergoing a hematopoietic stem cell transplantation: a systematic review and meta-analysis. Support Care Cancer 28, 3533–3542 (2020). https://doi.org/10.1007/s00520-020-05359-3

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