Measures of muscle and adipose tissue mass have been associated with outcomes in several malignancies, but studies in multiple myeloma (MM) are inconsistent. The aim of this study was to evaluate the association between muscle and fat areas and radiodensity, and overall survival (OS) in patients with newly diagnosed MM. We included 341 patients diagnosed with MM from 2010–2019 who had an 18F-fluorodeoxyglucose positron emission tomography/computed tomography at diagnosis. A cross-sectional image at the third lumbar vertebrae was segmented into muscle and fat components. Median follow up was 5.7 years. There was no association between sarcopenia and baseline disease characteristics or OS. Low muscle radiodensity was associated with higher disease stage, anemia, and renal failure. OS was 5.6 vs. 9.0 years in patients with muscle radiodensity in the lower vs. middle/upper tertiles, respectively (P = 0.02). High subcutaneous adipose tissue (SAT) radiodensity was associated with higher stage, anemia, thrombocytopenia, hypercalcemia, renal failure, and high LDH. OS was 5.4 years vs. not reached in patients with SAT radiodensity in the upper vs. middle/lower tertiles, respectively (P = 0.001). In conclusion, sarcopenia was not associated with OS in MM patients. High SAT radiodensity and low muscle radiodensity were associated with advanced disease stage and adverse laboratory characteristics.
肌肉和脂肪组织质量的测量指标已在多种恶性肿瘤中被证实与预后相关，但针对多发性骨髓瘤的研究结果并不一致。本研究旨在评估新诊断多发性骨髓瘤患者的肌肉和脂肪面积及放射密度与总生存期之间的关联。我们纳入了2010年至2019年间确诊的341例多发性骨髓瘤患者，所有患者在诊断时均接受了18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描检查。通过第三腰椎横截面图像分割出肌肉和脂肪成分。中位随访时间为5.7年。研究发现肌肉减少症与基线疾病特征或总生存期无显著关联。低肌肉放射密度与更高的疾病分期、贫血及肾功能衰竭相关。肌肉放射密度处于下三分位组患者的总生存期为5.6年，而中/上三分位组为9.0年（P=0.02）。高皮下脂肪组织放射密度与更高疾病分期、贫血、血小板减少、高钙血症、肾功能衰竭及高乳酸脱氢酶水平相关。皮下脂肪组织放射密度处于上三分位组患者的总生存期为5.4年，而中/下三分位组患者尚未达到中位生存期（P=0.001）。综上所述，肌肉减少症与多发性骨髓瘤患者总生存期无关，而高皮下脂肪组织放射密度和低肌肉放射密度均与疾病晚期分期及不良实验室特征相关。
Muscle and fat composition in patients with newly diagnosed multiple myeloma
肿瘤(癌症)患者之家