Sarcopenia in children and adolescents submitted to hematopoietic stem cell transplantation

Cláudia G Lewandowski; Adriana Garofolo; Heitor P Leite

doi:10.1016/j.htct.2024.01.005

Sarcopenia in children and adolescents submitted to hematopoietic stem cell transplantation

Hematol Transfus Cell Ther. 2024 Mar 4:S2531-1379(24)00037-3. doi: 10.1016/j.htct.2024.01.005. Online ahead of print.

Authors

Cláudia G Lewandowski¹, Adriana Garofolo², Heitor P Leite³

Affiliations

¹ Discipline of Pediatric Nutrition, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil.
² Institute for Care, Rehabilitation and Assistance in Neuropelveology and Gynecology (INCREASING), São Paulo, Brazil.
³ Discipline of Pediatric Nutrition, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil. Electronic address: heitorpons@gmail.com.

PMID: 38485546
DOI: 10.1016/j.htct.2024.01.005

Abstract

Background: Sarcopenia, characterized by decreased muscle mass, strength, and function, is associated with adverse outcomes. The prevalence of sarcopenia and the effect of the inflammatory response on muscle strength loss in children undergoing hematopoietic stem cell transplantation (HSCT) are unknown. This study aimed to estimate the prevalence of sarcopenia on admission and its associated clinical factors in children and adolescents undergoing HSCT and to determine the extent to which the systemic inflammatory response during hospitalization affects muscle strength.

Method: This was a prospective study of patients aged 6-18 years old undergoing HSCT. The outcome variables were the prevalence of sarcopenia on admission (loss of strength and skeletal muscle mass) and the loss of handgrip strength during hospitalization. Potential explanatory variables included age, sarcopenia, nutritional status and systemic inflammation as measured by serum C-reactive protein, albumin and ferritin concentrations.

Results: Eighty patients with a mean age of 11.5 (± 3.5) years were included. The main diagnoses were acute lymphocytic leukemia, acute myeloid leukemia and aplastic anemia. Eleven percent of patients had sarcopenia upon admission. Female sex, sarcopenia on admission (β coefficient: 0.70; 95% CI: -1.30 to -0.12; p-value = 0.018) and serum C-reactive protein concentration (β coefficient: -0.10; 95% CI: -0.16 to -0.04; p-value = 0.001) were associated with handgrip strength loss from admission to 14 days after HSCT.

Conclusion: Sarcopenia on admission and the degree of systemic inflammatory response are associated with decreased handgrip strength during hospitalization in pediatric patients undergoing HSCT. Further studies using the same criteria for diagnosing sarcopenia are required to enhance our understanding of these relationships.

Keywords: C-reactive protein, neoplasms; Child; Hematopoietic stem cell transplantation; Muscle strength, inflammation.