Analytic morphomics: a novel CT imaging approach to quantify adipose tissue and muscle composition in allogeneic hematopoietic cell transplantation

Chughtai, Komal; Song, Yeohan; P, Zhang; Derstine, Brian A.; Gatza, Erin; Friedman, Jeffrey F.; Hully, L; Inglis, Chandra; Goldstein, Steven C.; Magenau, John; Pawarode, Attaphol; Reddy, Pavan; Riwes, Mary; Yanik, Gregory A.; Wang, S C; Choi, Sung Won

doi:10.1038/bmt.2015.267

Cited by 19 publications

(16 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Analytic morphomics is a new and rapidly growing scientific discipline within precision pharmacotherapy that studies how variation in body size, composition, and structure are associated with drug STEPS TOWARD PRECISION PHARMACOTHERAPY Jennaro et al and disease response. 48 In sepsis, two recent metaanalyses have observed a paradox between body composition and survival, whereby particularly overweight (body mass index [BMI] between 25 and 29.9 kg/m 2 ), and to a lesser extent obese (BMI between 30 and 40 kg/m 2 ), patients tend to have better mortality outcomes compared with normal weight individuals (BMI between 18.5 kg/m 2 and 24.9 kg/m 2 ). 49,50 Notably, underweight (BMI less than 18.5 kg/m 2 ) and morbidly obese (BMI greater than 40 kg/m 2 ) patients were found to have similar risk of mortality relative to normal weight individuals.…”

Section: Morphomicsmentioning

confidence: 99%

Using l‐Carnitine as a Pharmacologic Probe of the Interpatient and Metabolic Variability of Sepsis

et al. 2020

View full text Add to dashboard Cite

Objective The objective of this review is to discuss the therapeutic use and differential treatment response to Levo‐carnitine (l‐carnitine) treatment in septic shock, and to demonstrate common lessons learned that are important to the advancement of precision medicine approaches to sepsis. We propose that significant interpatient variability in the metabolic response to l‐carnitine and clinical outcomes can be used to elucidate the mechanistic underpinnings that contribute to sepsis heterogeneity. Methods A narrative review was conducted that focused on explaining interpatient variability in l‐carnitine treatment response. Relevant biological and patient‐level characteristics considered include genetic, metabolic, and morphomic phenotypes; potential drug interactions; and pharmacokinetics (PKs). Main Results Despite promising results in a phase I study, a recent phase II clinical trial of l‐carnitine treatment in septic shock showed a nonsignificant reduction in mortality. However, l‐carnitine treatment induces significant interpatient variability in l‐carnitine and acylcarnitine concentrations over time. In particular, administration of l‐carnitine induces a broad, dynamic range of serum concentrations and measured peak concentrations are associated with mortality. Applied systems pharmacology may explain variability in drug responsiveness by using patient characteristics to identify pretreatment phenotypes most likely to derive benefit from l‐carnitine. Moreover, provocation of sepsis metabolism with l‐carnitine offers a unique opportunity to identify metabolic response signatures associated with patient outcomes. These approaches can unmask latent metabolic pathways deranged in the sepsis syndrome and offer insight into the pathophysiology, progression, and heterogeneity of the disease. Conclusions The compiled evidence suggests there are several potential explanations for the variability in carnitine concentrations and clinical response to l‐carnitine in septic shock. These serve as important confounders that should be considered in interpretation of l‐carnitine clinical studies and broadly holds lessons for future clinical trial design in sepsis. Consideration of these factors is needed if precision medicine in sepsis is to be achieved.

show abstract

Section: Morphomicsmentioning

confidence: 99%

Using l‐Carnitine as a Pharmacologic Probe of the Interpatient and Metabolic Variability of Sepsis

et al. 2020

View full text Add to dashboard Cite

show abstract

“…While body composition in HCT recipients has been previously assessed by dual-energy X-ray absorptiometry (DEXA), computed tomography (CT) imaging offers the advantage of increased accuracy and reproducibility [9,10]. CT has been established to assess body composition in patients with solid tumors [11][12][13] as well as hematologic malignancies [14], but studies addressing the use of CT to assess body composition in HCT survivors are just starting to emerge [15]. As many patients with lymphoma frequently undergo CT imaging as part of routine care during their treatment course, imaging data are readily available.…”

Section: Introductionmentioning

confidence: 99%

Evolution of Body Composition Following Autologous and Allogeneic Hematopoietic Cell Transplantation: Incidence of Sarcopenia and Association with Clinical Outcomes

DeFilipp

Troschel

Qualls

et al. 2018

Biology of Blood and Marrow Transplantation

View full text Add to dashboard Cite

Sarcopenia, the loss of muscle mass, has been identified as a potential risk factor for adverse outcomes in hematopoietic cell transplantation (HCT) recipients. However, much remains unknown about change in body composition following HCT. We retrospectively evaluated computed tomography (CT) imaging from 315 lymphoma patients undergoing HCT at our institution between 2000 and 2014. Cross-sectional areas of lean muscle, subcutaneous adipose tissue, and visceral adipose tissue were measured on CT at the level of the third lumbar vertebral body before HCT, 1-year post-HCT, and 2.5 years post-HCT. The incidence of sarcopenia before HCT was 47% in the autologous HCT (auto-HCT) cohort (n = 218) and 55% in the allogeneic HCT (allo-HCT) cohort (n = 97). Older age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01 to 1.04; P < .001) and male sex (OR, 4.59; 95% CI, 1.42 to 4.93; P < .001) were associated with sarcopenia before HCT. Increasing body mass index (OR, .78; 95% CI, .73 to .84; P < .001) was protective against sarcopenia before HCT. A significant decline in total lean body mass (β = 1.96; 95% CI, .79 to 3.13; P = .001) and increased sarcopenia incidence (OR, 1.72; 95% CI, 1.13 to 2.62, P = .012) was observed over time for patients in the allo-HCT cohort when compared with the trend in the auto-HCT cohort. Both auto-HCT and allo-HCT recipients experienced an increase in total body fat mass over time (β = 3.75; 95% CI, 2.77 to 4.73; P < .001). In multivariate analysis of patients undergoing allo-HCT, the presence of sarcopenia on baseline imaging before HCT was associated with a lower risk of acute graft-versus-host disease (OR, .30; 95% CI, .09 to .98; P = .047). In conclusion, we found that total body fat mass increases after both auto-HCT and allo-HCT. Following allo-HCT, total lean body mass significantly decreases corresponding to increased incidence of sarcopenia. Future studies are needed to further characterize changes in body composition in HCT recipients and investigate its impact on HCT outcomes.

show abstract

“…However, there are still few studies about the population of elderly patients undergoing HSCT. ( 80 - 82 )…”

Section: Assessment Of Body Composition In Elderly Patients Undergoinmentioning

confidence: 99%

Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Elderly

Gonçalves¹,

Ribeiro²,

Hirose³

et al. 2019

Einstein (São Paulo)

View full text Add to dashboard Cite

The Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Elderly was elaborated by nutritionists, nutrologists and hematologists physicians from 15 Brazilians reference centers in hematopoietic stem cell transplantation, in order to emphasize the importancy of nutritional status and the body composition during the treatment, as well as the main characteristics related to patient’s nutritional assessment. Establishing the consensus, we intended to improve and standardize the nutritional therapy during the hematopoietic stem cell transplantation. The Consensus was approved by the Brazilian Society of Bone Marrow Transplantation.

show abstract

Analytic morphomics: a novel CT imaging approach to quantify adipose tissue and muscle composition in allogeneic hematopoietic cell transplantation

Cited by 19 publications

References 12 publications

Using l‐Carnitine as a Pharmacologic Probe of the Interpatient and Metabolic Variability of Sepsis

Using l‐Carnitine as a Pharmacologic Probe of the Interpatient and Metabolic Variability of Sepsis

Evolution of Body Composition Following Autologous and Allogeneic Hematopoietic Cell Transplantation: Incidence of Sarcopenia and Association with Clinical Outcomes

Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Elderly

Contact Info

Product

Resources

About