Nutritional status of patients submitted to transplantation of allogeneic hematopoietic stem cells: a retrospective study

Abstract

ObjectiveThis study aimed to describe and compare the nutritional status of adult patients submitted to allogeneic hematopoietic stem cell transplantation at two different time points (admission and discharge).MethodsA retrospective, descriptive and quantitative study was performed based on clinical, laboratory and nutritional data obtained from medical records of adult patients of both genders submitted to allogeneic hematopoietic stem cell transplantation in a bone marrow transplantation reference center in Rio de Janeiro in the period from 2010 to 2013. Statistical analysis was performed using the SPSS software (version 22.0).ResultsSixty-four patients were evaluated. The mean age was 42.1 ± 3.2 years and the most prevalent disease was acute myeloid leukemia (39%). There was a high prevalence of gastrointestinal symptoms including nausea (100%), vomiting (97%) and mucositis (93%). Between admission and discharge there was a significant decrease in the median weight (−2.5 kg; 71.5 vs. 68.75 kg; p-value < 0.001), body mass index (−0.9 kg/m2; 24.8 vs. 24.4 kg/m2; p-value < 0.001), and serum albumin levels (−0.2 g/dL; 3.7 vs. 3.6 g/dL; p-value = 0.024). The survival time after hematopoietic stem cell transplantation correlated negatively with C-reactive protein at discharge (CC = −0.72; p-value < 0.001) and positively with serum albumin levels (CC = 0.56; p-value = 0.004) and with high total protein level at discharge (CC = 0.53; p-value = 0.006).ConclusionOur results suggest that patients submitted to allogeneic hematopoietic stem cell transplantation have compromised nutritional status during the hospital stay for transplantation.

Pre-transplant arm muscle area: a simple measure to identify patients at risk

“…In fact, in the present study, when the pre-HSCT BMI was measured, more than 50 % of the patients were above the normal range and only two were classified as undernourished. Patients above normal range for BMI were also found in other studies with patients undergoing HSCT [6,10,31]. This could be understood as an effect of nutritional transition which is observed in the admission of patients at hospitals [32].…”

Impact of Body Mass Index on Outcomes of Hematopoietic Stem Cell Transplantation in Adults

“…Clinical parameters of nutritional status have a limited effect on transplantation outcomes. Ferreira et al [9] and Rieger et al [13] evaluated changes in both serum albumin and total protein levels before and after transplantation, documenting decreases in both values that persisted through to discharge. In the study of Ferriera et al [9], higher serum albumin and total protein levels at discharge (not otherwise defined) were correlated with improved survival.…”

Caloric and protein intake in different periods of hospitalization of patients undergoing hematopoietic stem cell transplantation

“…Prevalence of excess weight in the analyzed samples was also reported by other studies. 9 , 18 , 19 , 20 This information might be explained by the increase in weight of the general population stemming from changes in feeding habits and lifestyle, 21 and might also be due to the submission of patients to an evaluation of the clinical conditions before undergoing transplantation.…”

“…HSCT patients are at increased nutritional risk due to the underlying disease, high metabolic demand and complications related to the conditioning regimen, which mostly affect the gastrointestinal tract, and are thus able to cause symptoms, such as nausea, vomiting, mucositis, odynophagia, diarrhea, abdominal pain and constipation, that make the ingestion of food and absorption of nutrients worse. 1 , 9 , 10 …”