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 explore 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, the prevalence of sarcopenia, 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. There was no significant difference in the prevalence of sarcopenia between patients who received ibrutinib and those who did not (p>0.05). While no significant changes were observed in SMI and TAMA values after treatment (p>0.05), a significant decrease in muscle density (HU) was observed (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 mortality (AUC>0.88). Conclusion: In this retrospective cohort, ibrutinib therapy was not associated with significant changes in skeletal muscle mass, while 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 interpreted as exploratory, and larger prospective studies incorporating functional assessments are needed to clarify the clinical implications of sarcopenia during ibrutinib therapy.