Prognostic Effect of Low Subcutaneous Adipose Tissue on Survival Outcome in Patients With Multiple Myeloma.
Increasing evidence suggests that decreased skeletal muscle mass (sarcopenia) or adipose tissue assessed using computed tomography (CT) predicts negative outcomes in patients with solid tumors. However, the prognostic value of such an assessment in multiple myeloma (MM) remains unknown.



Consecutive patients with newly diagnosed symptomatic MM were retrospectively analyzed. The cross-sectional area of skeletal muscles and subcutaneous or visceral adipose tissue was measured using CT. Body composition indexes (skeletal muscle index, subcutaneous adipose tissue index [SAI], and visceral adipose tissue index) were calculated. The association between these indexes and overall survival (OS) was examined.



Of 56 evaluable patients, 37 (66%) had sarcopenia. The 2-year OS in patients with SAI < median was 58% compared with 91% in those with SAI ≥ median (P = .006). In multivariate analyses, SAI < median was significantly associated with poor OS (hazard ratio, 4.05; P = .02). Sarcopenia was not associated with OS. The maximum value of the standardized uptake value was significantly higher in patients with SAI < median (P = .02).



The findings of this study suggest that low subcutaneous adipose tissue at baseline predicts poor survival outcome in patients with MM.
Department of Hematology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan; Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan. Electronic address: takeoka7@gmail.com.
Yasunobu
Y
Takeoka
Department of Hematology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan.
Kazuki
K
Sakatoku
Department of Hematology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan.
Akiko
A
Miura
Department of Hematology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan.
Ryosuke
R
Yamamura
Department of Hematology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan.
Taku
T
Araki
Department of PET Center, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan.
Hirotaka
H
Seura
Department of PET Center, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan.
Terue
T
Okamura
Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
Hideo
H
Koh
Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
Hirohisa
H
Nakamae
Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
Masayuki
M
Hino
Department of Hematology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan.
Kensuke
K
Ohta
D000368:Aged; D001823:Body Composition; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D018482:Muscle, Skeletal / Q000473:pathology; D000072078:Positron Emission Tomography Computed Tomography; D011379:Prognosis; D055948:Sarcopenia / Q000000981:diagnostic imaging / Q000473:pathology; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging / Q000473:pathology*; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed
Body composition; Computed tomography; Overall survival; Sarcopenia; Standardized uptake value