Background

In the era of combination therapy, there has been limited research on body composition. Specific body composition, such as sarcopenia, possesses the potential to serve as a predictive biomarker for toxic effects and clinical response in patients with urothelial carcinoma (UC) undergoing tislelizumab combined with gemcitabine and cisplatin (T + GC).

Materials and Methods

A total of 112 UC patients who received T + GC were selected at the Affiliated Hospital of Xuzhou Medical University from April 2020 to January 2023. Baseline patient characteristics and detailed hematological parameters were collected using the electronic medical system and laboratory examinations. The computed tomography images of patients were analyzed to calculate psoas muscle mass index (PMI). We evaluated the association between sarcopenia (PMI < 4.5 cm²/m² in men; PMI < 3.3 cm²/m² in women) and both hematological toxicity and tumor response.

Results

Overall, of the 112 patients (65.2% male, median age 56 years), 43 (38.4%) were defined as sarcopenia. Patients with sarcopenia were notably older (p = 0.037), more likely to have hypertension (p = 0.009), and had poorer ECOG-PS (p = 0.027). Patients with sarcopenia were more likely to develop leukopenia (OR 2.969, 95% CI 1.028–8.575, p = 0.044) after receiving at least two cycles of T + GC. However, these significant differences were not observed in thrombocytopenia and anemia. There were no significant differences in the tumor response and grade 3–4 hematological toxicity between patients with sarcopenia and those without sarcopenia.

Conclusions

Patients with sarcopenia were more likely to develop leukopenia after receiving T + GC. There were no notable alterations observed in relation to anemia or thrombocytopenia. No significant difference was found between the sarcopenia group and non-sarcopenia group in terms of tumor response and grade 3–4 hematological toxicity.

中文翻译：

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接受替雷利珠单抗联合吉西他滨和顺铂治疗的尿路上皮癌患者的肌肉减少症与白细胞减少症相关

背景

在联合治疗时代，对身体成分的研究有限。特定的身体成分，例如肌肉减少症，有可能作为接受替雷利珠单抗联合吉西他滨和顺铂 (T + GC) 治疗的尿路上皮癌 (UC) 患者的毒性反应和临床反应的预测生物标志物。

材料和方法

选取2020年4月至2023年1月在徐州医科大学附属医院接受T+GC治疗的112例UC患者。利用电子医疗系统和实验室检查收集患者基线特征和详细血液学参数。分析患者的计算机断层扫描图像以计算腰肌质量指数（PMI）。我们评估了肌少症（男性PMI < 4.5 cm ² /m ^{2 ；女性 PMI < 3.3 cm 2} /m ²）与血液学毒性和肿瘤反应之间的关联。

结果

总体而言，在 112 名患者中（65.2% 为男性，中位年龄 56 岁），43 名患者 (38.4%) 被定义为肌肉减少症。肌肉减少症患者年龄明显较大 ( p  = 0.037)，更有可能患有高血压 ( p  = 0.009)，且 ECOG-PS 较差 ( p  = 0.027)。肌少症患者 在接受至少两个周期的 T + GC 后更有可能出现白细胞减少症（OR 2.969，95% CI 1.028–8.575，p = 0.044）。然而，在血小板减少症和贫血症中没有观察到这些显着差异。肌肉减少症患者和非肌肉减少症患者之间的肿瘤反应和 3-4 级血液学毒性没有显着差异。

结论

肌少症患者在接受 T + GC 后更容易出现白细胞减少症。没有观察到与贫血或血小板减少症相关的显着变化。肌肉减少症组和非肌肉减少症组在肿瘤反应和3-4级血液学毒性方面没有发现显着差异。