Sarcopenia Diagnosis and Management in Hematological Malignancies and Differences with Cachexia and Frailty

SIMPLE SUMMARY: Sarcopenia is a geriatric syndrome characterized by progressive and generalized loss of muscle strength and muscle mass. It associated with reduced physical function and negative outcomes such as falls, hospitalization, loss of autonomy, disability, and mortality. Sarcopenia has bought value in the cancer management, given its impact on patients’ treatments and prognosis. In hematologic diseases, sarcopenia predicts toxicity, treatment’s response, influences overall survival and non-cancer-related risk of death. Diagnosing and properly framing sarcopenia is of great importance in designing the patient appropriate treatment and to perform a personalized or “tailor made” approach and supportive care. Early recognize sarcopenia allows to reverse the muscle loss process and to avoid negative impacts of sarcopenia syndrome on the patients’ trajectory. ABSTRACT: Sarcopenia is a geriatric syndrome characterized by a progressive loss of systemic muscle mass and decreased muscle strength or physical function. Several conditions have a role in its pathogenesis, significantly impacting adverse outcomes such as falls, functional decline, frailty, disability, multiple hospitalizations, and mortality. In the oncological setting, sarcopenia is associated with an increased risk of treatment toxicity, postoperative complications, and a higher mortality rate related to other causes (e.g., pneumonia). In the hematological field, even more so, sarcopenia predicts toxicity and response to treatments. In patients with hematologic malignancy, low muscle mass is associated with adverse outcomes and is a predictor of overall survival and non-relapse mortality. Therefore, it is essential to correctly recognize sarcopenia, evaluate the risk factors and their impact on the patient’s trajectory, and effectively treat sarcopenia. Sarcopenia is a reversible condition. The most effective intervention for reversing it is physical exercise combined with nutrition. The objective of clinical assessment focused on sarcopenia is to be able to carry out a “tailor-made treatment”.