Sarcopenia in children with acute leukemia worsened after induction therapy

Area of Science:

• Pediatric Oncology
• Muscle Physiology
• Medical Imaging

Background:

• Sarcopenia, the loss of skeletal muscle mass and function, is common in the elderly, with reduced insulin-like growth factor 1 (IGF-1) implicated.
• Muscle mass evaluation in pediatric patients with chronic conditions like acute leukemia is infrequent.
• Acute leukemia treatments can impact growth and body composition in children.

Purpose of the Study:

• To evaluate skeletal muscle mass in pediatric acute leukemia patients using computed tomography (CT) imaging.
• To examine the relationship between muscle mass changes and growth parameters, including IGF-1 levels, in these patients.
• To compare muscle mass in pediatric acute leukemia patients with non-chronic disease controls (implied, not explicitly stated in abstract).

Main Methods:

• Retrospective analysis of abdominal CT scans from 44 pediatric patients (age 1-15) with newly diagnosed acute leukemia before treatment.
• 15 patients also had CT scans post-induction therapy.
• Measurement of total psoas muscle area at lumbar vertebrae L3-4, body height, weight, and IGF-1 levels.

Main Results:

• A significant decrease in total psoas muscle area was observed in all 15 patients after induction therapy.
• A strong negative correlation (r = -0.84) was found between the rate of change in total psoas muscle area and IGF-1 levels in 9 patients.
• No correlation was found between muscle mass change and height velocity before or after treatment.

Conclusions:

• Pediatric acute leukemia patients experience skeletal muscle mass reduction following treatment initiation.
• Higher pre-treatment IGF-1 levels are associated with a greater degree of muscle mass loss.
• IGF-1 levels appear to be a significant factor in treatment-related muscle wasting in pediatric leukemia.