“Influence of Body Composition Assessed by Computed Tomography on Mortality in Older Adults Undergoing Hematopoietic Stem Cell Transplantation”

Abstract

Aim: The incidence of most hematologic malignancies increases with age. Hematopoietic stem cell transplantation (HSCT) provides a potentially life-prolonging or curative option for many patients in this scenario. Limited data is available on muscle mass and density assessed from CT-images on outcomes after HSCT. We aimed to evaluate the influence of body composition on morbidity and mortality in older adults undergoing (HSCT). Methods: Retrospective longitudinal study conducted with 50 patients ≥ 60 years undergoing HSCT at Hospital Israelita Albert Einstein, São Paulo. Body composition was assessed by chest computed tomography and treatment related mortality, graft versus host disease, neutrophil grafting, and overall survival were analyzed.Results: 148 HSCT patients were evaluated, 50 patients were eligible: 60% with autologous and 40% with allogeneic transplantation. Body mass index in patients was (female: 26.9 ± 4.7 kg/m2; 30.1± 4.9 kg/m2) - autologous and (female: 24.3 ± 5.15 kg/m2; male: 26.4 ± 2.0 kg/m2) - allogeneic. In autologous transplant group, we found a positive association between age and death risk with an increase of 63.5% in this risk (p=0.006) and also Karnofsky performance scale with decrease of 11.9% in death risk (p<0.001). A negative association between muscle radiodensity and death risk was observed in allogeneic transplantation patients with risk decrease of 20.1% (p = 0.032). We found a positive association between T4 muscle area and radiodensity with risk of acute graft versus host disease (p= 0.028). Conclusion: In population studied, body composition assessed by chest tomography showed the importance of radiodensity for better prognosis.