Sarcopenia in patients with multiple myeloma and autologous hematopoietic stem cell transplantation

Sarcopenia is defined as an age-related loss of muscle quantity as well as quality. Also, it is associated with morbidity and mortality. Multiple myeloma (MM) has a unique aspect with its bone involvement. We aimed to investigate the effect of hematopoietic stem cell transplantation on sarcopenia in MM patients using both CT and metabolic compartment of F-18 FDG PET/CT.

Patients with MM who received first-line treatment and were eligible for autologous stem cell transplantation (ASCT) were included. FDG PET images before transplantation and after 120 days of ASCT were recorded.

When were grouped as below and above 60 years of age, a decrease in muscle mass after treatment was observed in both groups (p<0.001). For patients older than 60 years, age was observed to have a significant effect on muscle mass, independent of the treatment (p=0.001). Regarding metabolic assessment of muscles with PET imaging, the lumbar region was observed to be affected by treatment for both age groups (p<0.001). Metabolic volume measurement of the femoral region did not show such difference related to treatment or age.

We observed a loss in muscle mass in patients with MM related with treatment. Since PET / CT imaging is routinely used to evaluate disease, it may also be used for the evaluation of muscle as quantity as quality. Awareness of sarcopenia should be increased in patients with MM and caregivers and be supported by physiotherapists to preserve and even to increase muscle mass and strength.