The Importance of Skeletal Muscle Quality Assessment in Elderly Patients with Acute Myeloid Leukemia

Ayaka Nishimura, Riki Sakata, Yasuko Miyahara, Mitsuru Itoh, Tomoo Okumura, Shunsuke Nakanishi
Purpose:

This study aimed to investigate skeletal muscle characteristics in elderly AML patients and their relationship to physical function.

Methods:

Cross-sectional data from 51 patients with initial diagnosed AML (31 men and 20 women, mean age: 65.5±15.8 years) were analyzed. Skeletal muscle mass and quality were assessed using computed tomography (CT). Cross-sectional area and CT values (Hounsfield Unit: HU) of the psoas and gluteus maximus muscles were evaluated, respectively. Physical function was assessed with the Cancer Functional Assessment Set (cFAS) specific to cancer patients. The subjects were divided into two groups: 20 patients under 65 years old (Control group) and 31 patients over 65 years old (Elderly group). Patient characteristics between the two groups were compared. In addition, correlations between skeletal muscle characteristics and age were investigated. Multiple regression analysis with age and sex-adjusted models was then used for evaluating the relationships between skeletal muscle characteristics (quality) and physical function.

Results:

The Elderly group had significantly lower gluteal maximus(HU: 33.68±9.16 vs 46.89±11.52; p0.01) and psoas(HU:33.68±9.16 vs 46.89±11.52; p0.01) quality than the Control group. Skeletal muscle mass was not significantly different between the two groups. The correlation between skeletal muscle characteristics and age was significant only for gluteal maximus (r=-0.655; 95% confidence interval [CI], -0.790 to -0.461; p0.01) and psoas (r=-0.597; 95%CI, -0.750 to -0.385; p0.01) muscle quality. Multiple regression analysis of physical function showed that the quality of gluteal maximus (β=0.60; standard error [SE], 0.19; p0.01) and psoas (β=0.57; SE,0.26 ; p0.05) muscles were related, adjusted for age and sex.

Conclusion(s):

Skeletal muscle characteristics showed that elderly AML patients had significantly lower in skeletal muscle quality, which decreased with age. In addition, skeletal muscle quality was also associated with physical function. This study suggests that muscle quality is more important than muscle mass in assessing skeletal muscle characteristics in elderly patients with AML.

Implications:

This study highlights the importance of skeletal muscle quality assessments for elderly patients with AML. Further research is needed including prospective studies with more cases and relevant factors.

Funding acknowledgements:
This study was not funded.
Keywords:
Elderly patients with AML
Skeletal muscle characteristics
Physical function
Primary topic:
Oncology, HIV and palliative care
Second topic:
Musculoskeletal
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Clinical Research Ethics Committee of Kyoto City Hospital
Provide the ethics approval number:
662
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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