急性リンパ性白血病

急性リンパ性白血病の小児のサルコペニアを調査した論文を紹介します。

Rayar Meera, et al. Sarcopenia in Children With Acute Lymphoblastic Leukemia. Journal of Pediatric Hematology/Oncology, doi: 10.1097/MPH.0b013e318279eea2

対象は91人の急性リンパ性白血病の小児で、筋肉量はDEXAで評価しています。結果ですが、6か月の治療後に筋肉量は低下し、診断後1-2年で部分的に回復しました。血清クレアチニンには変化を認めませんでした。早期治療時の筋肉量低下は入院期間と関連していました。

抄録しか読めていないので詳細不明ですが、広義のサルコペニアで考えれば、小児でもサルコペニアという言葉を使用することができます。広義のサルコペニアは高齢者だけの問題ではありません。診断基準はそのまま用いるわけにはいかないので、なかなか難しいかもしれませんが。

Abstract
Children with acute lymphoblastic leukemia experience musculoskeletal morbidity during therapy. We examined the patterns of change in skeletal muscle mass (SMM) and the relationship between change in SMM and the burden of illness as reflected in days of hospitalization. Ninety-one children had dual energy x-ray absorptiometry (DXA scans) during treatment, yielding the sum of lean tissue mass in all 4 limbs; the appendicular lean mass. SMM was derived from appendicular lean mass. The number of inpatient days was recorded. DXA scans at 5 time points showed a profile of change in SMM characterized by a drop in the mean Z score from -0.18 at diagnosis to -1.08 after 6 months of therapy, with a partial recovery 12 to 24 months after diagnosis. Levels of serum creatinine, a surrogate measure of SMM, were mainly unchanged. The extent of the drop in SMM during early therapy was associated with the duration of hospitalization (r=0.31, P<0 .05=".05" a="a" acute="acute" and="and" associated="associated" burden="burden" children="children" degree="degree" determine="determine" early="early" efficacy.="efficacy." experience="experience" findings="findings" for="for" illness.="illness." in="in" incomplete="incomplete" intervention="intervention" is="is" its="its" leukemia="leukemia" loss="loss" lymphoblastic="lymphoblastic" measure="measure" notable="notable" of="of" p="p" provide="provide" recovery.="recovery." reduction="reduction" smm="smm" target="target" the="the" therapeutic="therapeutic" these="these" to="to" treatment="treatment" with="with">