One‐Year Comparison of Body Composition in a Cohort of Patients with Multiple Myeloma
Authors: Yousef Mira , Geske Jenenne , Oliveto Jennifer , Khandalavala Birgit 
Published: May 2022

ObjectiveTo examine whether there are changes in body fat composition and skeletal muscle density over a one‐year period in a cohort of patients with multiple myeloma.HypothesisWe hypothesized that there are differences in specific body fat composition and skeletal muscle indices in a one‐year follow‐up for patients with multiple myeloma. These changes may predict the progression of disease more accurately and offer opportunities to improve outcomes with clinical intervention.MethodsThis is a retrospective cohort study examining preexisting CT scans of multiple myeloma (MM) patients from a midwestern healthcare system. Demographic information including age, sex, race, and BMI was gathered (Table 1). The body fat and skeletal muscle measurements were performed by one investigator using Aquarius iNtuition software version 4.4.12. To standardize the CT scan measurements, slices were taken at the third lumbar vertebra where both transverse processes were visible. Measurements were confirmed using tissue‐specific Hounsfield unit (HU) ranges of ‐190 to ‐30 for adipose tissue and ‐20 to 150 for skeletal muscle. All scans were measured in a light‐controlled radiological reading room and investigator training was performed under the supervision of a board‐certified radiologist who specializes in abdominal imaging.ResultsA total of 22 unique patients (14 women and 8 men) with MM were identified as having had two whole body low‐dose CT scans one year apart during the study period. In women, the mean visceral adipose tissue (VAT) area (cm2) and the subcutaneous adipose tissue (SQAT) area (cm2) decreased slightly from baseline to the one‐year follow‐up (Figure 1). The mean skeletal muscle density showed a small increase from baseline to follow‐up. Men also showed a small decrease visceral adipose tissue (VAT) area (cm2) and the subcutaneous adipose tissue (SQAT) area (cm2) from baseline to one‐year follow‐up. In contrast to women, they showed a small decrease from baseline to follow‐up. All changes were non‐significant.ConclusionsWe performed a retrospective analysis of changes in body fat composition and skeletal muscle density in multiple myeloma patients over a one‐year period. Previous studies have shown that higher SQAT is associated with worse overall survival. However, we found no changes in any of our parameters over the course of one year that would indicate a trend towards disease progression. Further follow‐up may be needed over a longer time period. Additionally, a larger sample with more complete imaging records is needed to make stronger conclusions. More reliable prognostic biomarkers would help determine current disease burden.1. Gomez‐Perez SL, Haus JM, Sheean P, et al. Measuring abdominal circumference and skeletal muscle from a single cross‐sectional computed tomography image: A step‐by‐step guide for clinicians using National Institutes of Health ImageJ. J Parenter Enter Nutr. 2016;40(3):308‐318. doi:10.1177/01486071156041492. Da Cunha, Ademar Dantas, et al. “Adipose Tissue Radiodensity: A New Prognostic Biomarker in People with Multiple Myeloma.” Nutrition, vol. 86, 2021, p. 111141., https://doi.org/10.1016/j.nut.2021.111141.