Incidence of pretransplant sarcopenia and its effect on prognosis in patients receiving hematopoietic stem cell transplantation: a meta-analysis / 中华临床营养杂志

ABSTRACT

Objective:To evaluate the incidence of pretransplant sarcopenia and its effect on prognosis in patients receiving hematopoietic stem cell transplantation (HSCT).Methods:Several electronic databases (PubMed, Embase, Web of Science, Cochrane Library, EBSCO, CINAHL, CBM, CNKI, VIP, WanFang data) were searched from inception to March 2022. Cohort and case-control studies on the outcomes of HSCT patients with pre-transplant sarcopenia were collected, and the quality of the studies was evaluated using the Newcastle-Ottawa Scale. After literature screening, data extraction and quality evaluation, meta-analysis was performed using RevMan 5.3.Results:9 cohort studies were included, of which 6 were of high quality and 3 were of medium quality. The total sample size was 2,255 cases, including 862 cases in the sarcopenia group. The incidence of pretransplant sarcopenia in HSCT patients was 40% (95% CI 0.35 to 0.46). Pretransplant sarcopenia was associated with decreased overall survival rate ( HR = 1.73, 95% CI 1.38 to 2.04, P = 0.04) and increased non-relapse mortality after transplantation ( HR = 1.84,95% CI 1.47 to 2.32, P < 0.01). There was no significant correlation between pretransplant sarcopenia and the incidence of acute graft-versus-host disease ( OR = 1.08, 95% CI 0.84 to 1.39, P = 0.55). Sarcopenia before transplantation had no significant effect on the duration of hospital stay ( MD = 3.57, 95% CI -0.13 to 7.26, P = 0.06). Conclusions:Pretransplant sarcopenia was associated with reduced overall survival and increased non-relapse mortality after transplantation. More attention to pretransplant sarcopenia is needed domestically and large-scale, multi-center, prospective studies assessing early screening for sarcopenia are necessary to provide guidance about prevention and treatment strategies.