Prognostic Value of Myosteatosis Assessed by Computed Tomography in Patients with Multiple Myeloma

Purpose or Learning Objective: Myosteatosis is associated with increased frailty, decreased muscle, and mobility function that seem fairly prevalent in multiple myeloma (MM) patients. This study aimed to determine the prognostic value of myosteatosis assessed by computed tomography (CT) for progression-free survival (PFS) and overall survival (OS).

Methods or Background: This cohort study approved by the institutional review board consisted of patients with newly diagnosed MM who were treated at a single university hospital and received CT at baseline. Geriatric assessment was performed via the International Myeloma Working Group (IMWG) frailty score and Revised Myeloma Comorbidity Index (R-MCI). Myosteatosis was determined through paravertebral CT measurement of skeletal muscle radiodensity. The myeloma outcome was defined via PFS and OS assessment. Statistical analyses included univariable and multivariable Cox proportional hazard models and the Kaplan-Meier method.

Results or Findings: A total of 226 newly diagnosed MM patients (median age: 65 years [range: 29–89], 63% males, mean body mass index (BMI): 25 [range: 14–42]) were analyzed. The prevalence of myosteatosis was 60%. Muscle radiodensity was significantly decreased in individuals with International Staging System stage III versus I (p < 0.001), indicating higher amounts of intermuscular adipose tissue in patients with advanced disease. Median PFS and OS of the whole population were 3.4 years and 7.6 years, respectively. In univariable analysis, myosteatosis was a statistically valuable predictor of impaired PFS and OS (hazard ratio [HR]: 1.70; 95% confidence interval [CI], 1.16–2.50, and HR: 2.44; 95% CI, 1.45–4.11). Myosteatosis remained an independent predictor of OS in multivariable analyses.

Conclusion: Myosteatosis seems highly prevalent in patients with newly diagnosed MM and is associated with impaired OS. Prospective clinical trials are required to better understand the role of myosteatosis in MM patients.

Publikationsverlauf

Artikel online veröffentlicht:
02. Juni 2022