Sarcopenia predicts overall survival in patients with malignant hematological diseases: A meta-analysis

Summary

Background & aims

Our purpose was to analyze influence of sarcopenia on overall survival (OS) in patients with malignant hematological diseases (MHD) based on a large sample.

Methods

MEDLINE, EMBASE, and SCOPUS databases were screened for associations between sarcopenia and OS in MHD up to December 2019. Overall, 7 studies met the inclusion criteria. The methodological quality of the involved studies was checked according to the QUADAS instrument. The meta-analysis was undertaken using RevMan 5.3 software.

Results

The included 7 studies comprised 1578 patients. There were different MHD: diffuse large B cell lymphoma (DLBCL, 4 studies, 573 patients, 36.3%), acute leukemias and/or myelodysplastic syndrome (2 studies, 949 patients, 60.1%), and multiple myeloma (one study, 56 patients, 3.6%). Sarcopenia identified on CT examinations was reported in 617 patients (39.1%, range, 24.6%–66.1%). In the overall sample, showed that sarcopenia was associated with lower OS (simple regression: HR 2.15, CI 95% 1.42–3.25, p < 0.0003; multiple regression: HR = 1.94, CI 95% 1.30–2.90, p < 0.001). Furthermore, the role of sarcopenia was analyzed in DLBCL and acute leukemias/myelodysplastic syndrome. In DLBCL, sarcopenia was associated with lower OS (simple regression: HR 3.05, CI 95% 2.30–4.05, p < 0.00001; multiple regression: HR = 2.39, CI 95% 1.77–3.22, p < 0.00001). In leukemias, sarcopenia was associated with lower OS in simple regression only (simple regression: HR 1.57, CI 95% 1.07–2.31, p < 0.02; multiple regression HR = 1.82, CI 95% 0.92–3.58, p < 0.08).

Conclusions

Sarcopenia is an independent predictor of OS in patients with DLBCL underwent chemotherapy.