The effect of ibrutinib therapy on sarcopenia in patients with hematologic malignancies

Abstract

Aim: Sarcopenia, characterized by progressive loss of skeletal muscle mass and function, is associated with poor prognosis in patients with hematologic malignancies. Given the potential musculoskeletal effects of Bruton tyrosine kinase inhibitors, this study aimed to investigate sarcopenia-related parameters in patients with hematologic malignancies receiving ibrutinib therapy.

Materials and Methods: This retrospective study included 55 patients diagnosed with hematologic malignancies. Using computed tomography (CT) images obtained before and after ibrutinib therapy, we calculated total abdominal muscle area (TAMA), skeletal muscle index (SMI), and muscle density in Hounsfield Units (HU). Changes in these imaging-based parameters, sarcopenia prevalence, and their associations with mortality were statistically analyzed.

Results: The mean age of the patients was 67.38 ± 8.66 years, and 72.7% were male. No significant difference in the prevalence of sarcopenia was observed between patients who received ibrutinib and those who did not (p>0.05). While SMI and TAMA values did not change significantly after treatment (p>0.05), muscle density (HU) decreased significantly (p=0.001). In the ROC analysis, baseline and follow-up SMI values in females, as well as follow-up SMI values in males, showed good discriminatory ability for predicting mortality (AUC>0.88).

Conclusion: In this retrospective cohort, ibrutinib therapy was not associated with significant changes in skeletal muscle mass; however, a decline in muscle density was observed, suggesting potential alterations in muscle quality. No restorative effect on pre-existing sarcopenia was demonstrated in this limited cohort. These findings should be considered exploratory; larger prospective studies that incorporate functional assessments are needed to clarify the clinical implications of sarcopenia in patients receiving ibrutinib.