CardioSomaticsCardioSomaticsCardioСоматика2221-71852658-5707Eco-Vector67724710.17816/CS677247KCQOITReviewsОбзорыReview ArticlePrevalence and clinical significance of sarcopenia in patients with chronic myeloproliferative neoplasms: epidemiology, diagnosis, and intervention strategiesРаспространённость и клиническое значение саркопении у пациентов с хроническими миелопролиферативными заболеваниями: эпидемиология, диагностика и стратегии вмешательстваhttps://orcid.org/0000-0003-4191-86387501-6951GarifullinaAdelina G.ГарифуллинаАделина Гарифовна
Russian Federation
nakieva-1@yandex.ruhttps://orcid.org/0000-0002-3297-16089464-0504BakirovBulat A.БакировБулат Ахатович
Russian Federation

MD, Dr. Sci. (Medicine), Associate Professor

д-р мед. наук, доцент

bakirovb@gmail.comhttps://orcid.org/0000-0001-5193-21645887-8878LasynovaGulnaz H.ЛасыноваГульназ Хайбулловна
Russian Federation
lasynova1987@mail.ruhttps://orcid.org/0009-0003-5307-31235655-9766GoldyrevEvgeny O.ГолдыревЕвгений Олегович
Russian Federation
evgenyy86@gmail.comhttps://orcid.org/0000-0003-1878-44674129-7880KudlayDmitry A.КудлайДмитрий Анатольевич
Russian Federation

MD, Dr. Sci. (Medicine); Сorresponding member of the Russian Academy of Sciences

д-р мед. наук, чл.-корр. РАН

D624254@gmail.comBashkir State Medical UniversityБашкирский государственный медицинский университетSechenov First Moscow State Medical UniversityПервый Московский государственный медицинский университет им. И.М. СеченоваNational Research Center — Institute of Immunology FMBA of RussiaГосударственный научный центр «Институт иммунологии» ФМБА России27052025110620251621471551703202524042025Copyright ©; 2025, Eco-VectorCopyright ©; 2025, ООО "Эко-Вектор"2025Eco-VectorООО "Эко-Вектор"https://creativecommons.org/licenses/by-nc-nd/4.0https://cardiosomatics.ru/2221-7185/article/view/677247

Chronic myeloproliferative neoplasms (MPNs) are a group of clonal hematopoietic disorders that predominantly affect older patients. These conditions are associated with increased risk of numerous complications. One of the key comorbidities in these patients is sarcopenia—a progressive loss of skeletal muscle mass, strength, and function—that significantly worsens quality of life and the prognosis of the underlying disease. The work aimed to systematize current data on the impact of sarcopenia on outcomes in patients with MPNs and to summarize recommendations for its early diagnosis and management to improve clinical outcomes. The review presents data on the epidemiology, pathogenesis, and clinical relevance of sarcopenia in patients with MPNs. Particular attention is given to the role of chronic inflammation, protein metabolism disorders, the consequences of antitumor therapy, and age-related changes in the development of muscle atrophy. The importance of early diagnosis of sarcopenia using modern tools—such as the SARC-F questionnaire, bioelectrical impedance analysis, and various physical performance tests—is emphasized. Strategies for correcting sarcopenia are presented, including physical exercise, nutritional support, and other approaches that may improve patient prognosis and quality of life. This work is of particular relevance to hematologists, geriatricians, and rehabilitation specialists involved in the care of patients with MPNs. Research into sarcopenia in the context of MPNs remains highly relevant, as timely diagnosis and management may significantly influence clinical outcomes.

Хронические миелопролиферативные заболевания (ХМПЗ) представляют собой группу клональных гемопоэтических расстройств, преимущественно встречающихся у пожилых пациентов. Эти заболевания ассоциируются с повышенным риском развития многочисленных осложнений. Одним из ключевых сопутствующих состояний у таких пациентов является саркопения — прогрессирующая потеря мышечной массы, силы и функциональности, которая значительно ухудшает качество жизни и прогноз основного заболевания. Цель работы — систематизировать современные данные о влиянии саркопении на прогноз пациентов с ХМПЗ и обобщить рекомендации по её ранней диагностике и коррекции для улучшения клинических исходов. В данном обзоре представлены данные об эпидемиологии, патогенезе и клиническом значении саркопении у пациентов с ХМПЗ. Особое внимание уделено роли хронического воспаления, нарушений белкового обмена, последствий противоопухолевой терапии и возрастных изменений в развитии мышечной атрофии. Подчёркивается важность ранней диагностики саркопении с использованием современных инструментов, таких как опросник SARC-F, биоимпедансометрия, различные тесты для оценки физической работоспособности. Представлены стратегии коррекции саркопении, включающие физические нагрузки, нутритивную поддержку и другие подходы, способные улучшить прогноз и качество жизни пациентов. Работа имеет важное значение для гематологов, гериатров и реабилитологов, занимающихся ведением пациентов с ХМПЗ. Исследование саркопении при ХМПЗ является актуальной задачей, поскольку её своевременная диагностика и коррекция могут существенно повлиять на клинические исходы.

myeloproliferative disorderssarcopeniamuscle strengthmuscle massхронические миелопролиферативные заболеваниясаркопениямышечная силамышечная массаDameshek W. Some speculations on the myeloproliferative syndromes [editorial]. Blood. 1951;6(4):372–375. Blood. 2016;127(6):663. doi: 10.1182/blood-2015-12-686402Melikyan AL, Subortseva IN, Kovrigina AM, et al. National clinical guidelines on diagnosis and treatment of Ph-negative myeloproliferative neoplasms (polycythemia vera, essential thrombocythemia, and primary myelofibrosis) (edition 2024). Clinical oncohematology. 2024;17(3):291–334. doi: 10.21320/2500-2139-2024-17-3-291-334 EDN: LBZGTOKhoury JD, Solary E, Abla O, et al. The 5th edition of the World Health Or-ganization Classification of Haematolymphoid Tumours: Myeloid and Histiocytic/Dendritic Neoplasms. Leukemia. 2022;36(7):1703–19. doi: 10.1038/s41375-022-01613-1Mancuso S, Accurso V, Santoro M, et al. The Essential Thrombocythemia, Thrombotic Risk Stratification, and Cardiovascular Risk Factors. Adv Hematol. 2020;2020:9124821. doi: 10.1155/2020/9124821Slot S, Dinmohamed AG, Visser O, Te Boekhorst PAW, Zweegman S. Survival in Primary Myelofibrosis: A Population-based Analysis in the Netherlands. Hemasphere. 2021;5(7):e595. doi: 10.1097/HS9.0000000000000595Bankar AR. Association of frailty with clinical outcomes in myeloproliferative neoplams: a population-based study from Ontario, Canada. A thesis submitted in conformity with the requirements for the degree of Master of Science (Clinical Epidemiology) Institute of Health Policy, Management and Evaluation University of Toronto (ON, Canada 2022). Toronto, 2022. Р. 1–105.Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31. doi: 10.1093/ageing/afy169Dogru Gunduz H, Yildirim T, Ersoy Y. Sarcopenia and clinical presentation. Annals of Medical Research. 2021;24(1):0121–0126. Available from: https://annalsmedres.org/index.php/aomr/article/view/2121Biolo G, Cederholm T, Muscaritoli M. Muscle contractile and metabolic dysfunction is a common feature of sarcopenia of aging and chronic diseases: from sarcopenic obesity to cachexia. Clin Nutr. 2014;33(5):737–748. doi: 10.1016/j.clnu.2014.03.007Williams GR, Dunne RF, Giri S, Shachar SS, Caan BJ. Sarcopenia in the Older Adult With Cancer. J Clin Oncol. 2021;39(19):2068–2078. doi: 10.1200/JCO.21.00102Efe M, Saraç ZF, Savaş S, Kilavuz A, Akçi-Çek SF. Sarcopenia prevalence and the quality of life in older adults: A study from Turkey’s east. Ege Tıp Dergisi. 2021;(60 Suppl):52–59. doi: 10.19161/etd.915678Yuan S, Larsson SC. Epidemiology of sarcopenia: Prevalence, risk factors, and consequences. Metabolism. 2023;144:155533. doi: 10.1016/j.metabol.2023.155533Petermann-Rocha F, Balntzi V, Gray SR, et al. Global prevalence of sarcopenia and severe sarcopenia: a systematic review and meta-analysis. J cachexia sarcopenia muscle. 2022;13(1):86–99. doi: 10.1002/jcsm.12783Verdijk LB, Snijders T, Drost M, et al. Satellite cells in human skeletal muscle; from birth to old age. Age (Dordr). 2014;36(2):545–547. doi: 10.1007/s11357-013-9583-2Frontera WR, Zayas AR, Rodriguez N. Aging of human muscle: understanding sarcopenia at the single muscle cell level. Phys Med Rehabil Clin N Am. 2012;23(1):201–207, xiii. doi: 10.1016/j.pmr.2011.11.012Ciciliot S, Rossi AC, Dyar KA, Blaauw B, Schiaffino S. Muscle type and fiber type specificity in muscle wasting. Int J Biochem Cell Biol. 2013;45(10):2191–2199. doi: 10.1016/j.biocel.2013.05.016Edström E, Altun M, Bergman E, et al. Factors contributing to neuromuscular impairment and sarcopenia during aging. Physiol Behav. 2007;92(1–2):129–135. doi: 10.1016/j.physbeh.2007.05.040Fulop T, Larbi A, Dupuis G, et al. Immunosenescence and Inflamm-Aging As Two Sides of the Same Coin: Friends or Foes? Front Immunol. 2017;8:1960. doi: 10.3389/fimmu.2017.01960Walrand S, Zangarelli A, Guillet C, et al. Effect of fast dietary proteins on muscle protein synthesis rate and muscle strength in ad libitum-fed and energy-restricted old rats. Br J Nutr. 2011;106(11):1683–1690. doi: 10.1017/S0007114511002182Huang JH, Hood DA. Age-associated mitochondrial dysfunction in skeletal muscle: Contributing factors and suggestions for long-term interventions. IUBMB Life. 2009;61(3):201–214. doi: 10.1002/iub.164Ferri E, Marzetti E, Calvani R, Picca A, Cesari M, Arosio B. Role of Age-Related Mitochondrial Dysfunction in Sarcopenia. Int J Mol Sci. 2020;21(15):5236. doi: 10.3390/ijms21155236Ji LL. Exercise at old age: does it increase or alleviate oxidative stress? Ann N Y Acad Sci. 2001;928:236–247. doi: 10.1111/j.1749-6632.2001.tb05653.xSun MY, Chang CL, Lu CY, Wu SY, Zhang JQ. Sarcopenia as an Independent Risk Factor for Specific Cancers: A Propensity Score-Matched Asian Population-Based Cohort Study. Nutrients. 2022;14(9):1910. doi: 10.3390/nu14091910Peterson SJ, Mozer M. Differentiating Sarcopenia and Cachexia Among Patients With Cancer. Nutr Clin Pract. 2017;32(1):30–39. doi: 10.1177/0884533616680354Pin F, Couch ME, Bonetto A. Preservation of muscle mass as a strategy to reduce the toxic effects of cancer chemotherapy on body composition. Curr Opin Support Palliat Care. 2018;12(4):420–426. doi: 10.1097/SPC.0000000000000382Vega MC, Laviano A, Pimentel GD. Sarcopenia and chemotherapy-mediated toxicity. Einstein (Sao Paulo). 2016;14(4):580–584. doi: 10.1590/S1679-45082016MD3740Bauer J, Morley JE, Schols AMWJ, et al. Sarcopenia: A Time for Action. An SCWD Position Paper. J Cachexia Sarcopenia Muscle. 2019;10(5):956–961. doi: 10.1002/jcsm.12483Mendes MCS, Pimentel GD, Costa FO, Carvalheira JBC. Molecular and neuroendocrine mechanisms of cancer cachexia. J Endocrinol. 2015;226(3):R29–43. doi: 10.1530/JOE-15-0170Calvani R, Picca A, Cesari M, et al. Biomarkers for Sarcopenia: Reductionism vs. Complexity. Curr Protein Pept Sci. 2018;19(7):639–642. doi: 10.2174/1389203718666170516115422Gupta P, Kumar S. Sarcopenia and Endocrine Ageing: Are They Related? Cureus. 2022;14(9):e28787. doi: 10.7759/cureus.28787Yang M, Hu X, Xie L, et al. Comparing Mini Sarcopenia Risk Assessment With SARC-F for Screening Sarcopenia in Community-Dwelling Older Adults. J Am Med Dir Assoc. 2019;20(1):53–57. doi: 10.1016/j.jamda.2018.04.012Yang M, Jiang J, Zeng Y, Tang H. Sarcopenia for predicting mortality among elderly nursing home residents: SARC-F versus SARC-CalF. Medicine (Baltimore). 2019;98(7):e14546. doi: 10.1097/MD.0000000000014546Malmstrom TK, Miller DK, Simonsick EM, Ferrucci L, Morley JE. SARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes. J Cachexia Sarcopenia Muscle. 2016;7(1):28–36. doi: 10.1002/jcsm.12048Grigorieva II, Raskina TA, Letaeva MV, et al. Sarcopenia: pathogenesis and diagnosis. Fundamental and clinical medicine. 2019;4(4):105–116. doi: 10.23946/2500-0764-2019-4-4-105-116 EDN: QPGMAQZakrevsky AI, Fedorova AA, Pasechnik IN, Kutepov DE. Sarcopenia and its diagnosis. Clinical nutrition and metabolism. 2021;2(1):13–22. doi: 10.17816/clinutr71107 EDN: ZEUOEQMasenko VL, Kokov AN, Grigoreva II, Krivoshapova KE. Radiology methods of the sarcopenia diagnosis. Issled prakt med (Print). 2019;6(4):127–137. doi: 10.17709/2409-2231-2019-6-4-13Samoilova IuG, Matveeva MV, Khoroshunova EA, et al. Body composition in sarcopenia in middle-aged individuals. Therapeutic Archive. 2022;94(10):1149–1154. doi: 10.26442/00403660.2022.10.201878 EDN: GHRGKZKhoroshunova EA, Samoilova YuG, Matveeva MV, et al. Current methods for sarcopenia diagnosis in patients with impaired carbohydrate metabolism. Russian Journal of Preventive Medicine. 2022;25(10):116–121. doi: 10.17116/profmed202225101116 EDN: MBMYTKGaivoronskiy IV, Nichiporuk GI, Gaivoronskiy IN, Nichiporuk NG. Bioimpedansometry as a method of the component bodystructure assessment (review). Bulletin of St. Petersburg University. Medicine. 2017;12(4):365–384. doi: 10.21638/11701/spbu11.2017.406. EDN: YNSXGCTagliafico AS, Bignotti B, Torri L, Rossi F. Sarcopenia: how to measure, when and why. Radiol med. 2022;127(3):228–237. doi: 10.1007/s11547-022-01450-3Albano D, Messina C, Vitale J, Sconfienza LM. Imaging of sarcopenia: old evidence and new insights. Eur Radiol. 2020;30(4):2199–2208. doi: 10.1007/s00330-019-06573-2Beaudart C, McCloskey E, Bruyère O, et al. Sarcopenia in daily practice: assessment and management. BMC Geriatr. 2016;16(1):170. doi: 10.1186/s12877-016-0349-4Beaudart C, Rolland Y, Cruz-Jentoft AJ, et al. Assessment of Muscle Function and Physical Performance in Daily Clinical Practice : A position paper endorsed by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Calcif Tissue Int. 2019;105(1):1–14. doi: 10.1007/s00223-019-00545-wBruyère O, Beaudart C, Reginster JY, et al. Assessment of muscle mass, muscle strength and physical performance in clinical practice: An international survey. European Geriatric Medicine. 2016;7(3):243–246. doi: 10.1016/j.eurger.2015.12.009Maggio M, Ceda GP, Ticinesi A, et al. Instrumental and Non-Instrumental Evaluation of 4-Meter Walking Speed in Older Individuals. PLoS One. 2016;11(4):e0153583. doi: 10.1371/journal.pone.0153583Rydwik E, Bergland A, Forsén L, Frändin K. Investigation into the reliability and validity of the measurement of elderly people’s clinical walking speed: a systematic review. Physiother Theory Pract. 2012;28(3):238–256. doi: 10.3109/09593985.2011.601804Csapo R, Alegre LM. Effects of resistance training with moderate vs heavy loads on muscle mass and strength in the elderly: A meta-analysis. Scand J Med Sci Sports. 2016;26(9):995–1006. doi: 10.1111/sms.12536Roth SM, Ferrell RF, Hurley BF. Strength training for the prevention and treatment of sarcopenia. J Nutr Health Aging. 2000;4(3):143–155.Bauer J, Biolo G, Cederholm T, et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc. 2013;14(8):542–559. doi: 10.1016/j.jamda.2013.05.021Bauer JM, Verlaan S, Bautmans I, et al. Effects of a vitamin D and leucine-enriched whey protein nutritional supplement on measures of sarcopenia in older adults, the PROVIDE study: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc. 2015;16(9):740–747. doi: 10.1016/j.jamda.2015.05.021Liao CD, Tsauo JY, Wu YT, et al. Effects of protein supplementation combined with resistance exercise on body composition and physical function in older adults: a systematic review and meta-analysis. Am J Clin Nutr. 2017;106(4):1078–1091. doi: 10.3945/ajcn.116.143594Bear DE, Langan A, Dimidi E, et al. β-Hydroxy-β-methylbutyrate and its impact on skeletal muscle mass and physical function in clinical practice: a systematic review and meta-analysis. Am J Clin Nutr. 2019;109(4):1119–1132. doi: 10.1093/ajcn/nqy373Use of high-dose matrix formulation of vitamin D for the prevention and treatment of vitamin d deficiency, including in comorbid patients. Therapeutic Archive. 2024;96(10):992–1006. doi: 10.26442/00403660.2024.10.203016 EDN: NXPUJXBeaudart C, Buckinx F, Rabenda V, et al. The effects of vitamin D on skeletal muscle strength, muscle mass, and muscle power: a systematic review and meta-analysis of randomized controlled trials. J Clin Endocrinol Metab. 2014;99(11):4336–4345. doi: 10.1210/jc.2014-1742Polo-Ferrero L, Recio-Rodriguez JI, González-Manzano S, et al. Nutritional intake as a determinant of high-speed resistance and multicomponent training efficacy on strength in older women at risk of sarcopenia. A randomized clinical trial. Clin Nutr. 2025;47:103–111. doi: 10.1016/j.clnu.2025.02.015Skinner JW, Otzel DM, Bowser A, et al. Muscular responses to testosterone replacement vary by administration route: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle. 2018;9(3):465–481. doi: 10.1002/jcsm.12291Albert SG, Morley JE. Testosterone therapy, association with age, initiation and mode of therapy with cardiovascular events: a systematic review. Clin Endocrinol (Oxf). 2016;85(3):436–443. doi: 10.1111/cen.13084De Spiegeleer A, Beckwée D, Bautmans I, Petrovic M. Sarcopenia Guidelines Development group of the Belgian Society of Gerontology and Geriatrics (BSGG). Pharmacological Interventions to Improve Muscle Mass, Muscle Strength and Physical Performance in Older People: An Umbrella Review of Systematic Reviews and Meta-analyses. Drugs Aging. 2018;35(8):719–734. doi: 10.1007/s40266-018-0566-y