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Prediction of clinical outcomes through assessment of sarcopenia and adipopenia using computed tomography in adult patients with acute myeloid leukemia

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Abstract

Sarcopenia and adipopenia have prognostic significance in cancer. Analysis of a single abdominal computed tomography (CT) section at the third lumbar vertebra has been widely adopted for this purpose. The approach using a single section at the first lumbar vertebra level (L1) may extend clinical viability. We evaluated the prognostic value of sarcopenia and adipopenia assessed using a CT section at L1 in acute myeloid leukemia (AML). Data from 96 patients with available imaging were retrospectively reviewed. Patients with sarcopenia (37.5%) had significantly worse overall survival (OS) (median 17.8 months vs. not reached, p = 0.038) and treatment-related mortality (TRM) (22.2% vs. 3.0%, p = 0.0019) than those without. Subcutaneous adipopenia (51.0%) was significantly associated with inferior OS (median 17.9 months vs. not reached, p = 0.0011), progression-free survival (PFS) (median 6.2 months vs. not reached, p = 0.004), and TRM (16.3% vs. 4%, p = 0.024). Visceral adipopenia (30.2%) was associated with poor OS (12.7 vs. 31.7 months, p = 0.0055) and PFS (3.7 vs. 31.7 months, p = 0.003). Multivariable analyses found sarcopenia, subcutaneous adipopenia and visceral adipopenia were significant negative prognostic factors for OS. Sarcopenia and adipopenia assessed using a single CT section at the L1 level are useful in predicting the prognosis of AML.

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Acknowledgements

This study was supported by the National Cancer Center, Korea, Grant NCCCDA2018-07 and NCC-1810160-2. Presented at the International Conference and 60th Annual Meeting (ICKSH), Korean Society of Hematology (KSH), 2019.

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Authors and Affiliations

  1. Center for Hematologic Malignancy, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, Geyonggi, 410-769, Republic of Korea

    Jongheon Jung, Eunyoung Lee, Hyeon-Seok Eom & Hyewon Lee

  2. Department of Laboratory Medicine, National Cancer Center, Goyang, Korea

    Hyoeun Shim

  3. Department of Statistics, Dongguk University, Seoul, Korea

    Ju-Hyun Park

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  1. Jongheon Jung
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Jung, J., Lee, E., Shim, H. et al. Prediction of clinical outcomes through assessment of sarcopenia and adipopenia using computed tomography in adult patients with acute myeloid leukemia. Int J Hematol 114, 44–52 (2021). https://doi.org/10.1007/s12185-021-03122-w

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  • DOI: https://doi.org/10.1007/s12185-021-03122-w

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