Severe weight loss in 3 months after allogeneic hematopoietic SCT was associated with an increased risk of subsequent non-relapse mortality

Abstract

Patients after allogeneic hematopoietic SCT (HSCT) are at risk of malnutrition. To assess the impact of malnutrition after allogeneic HSCT on transplant outcomes, we conducted a retrospective study. Adult patients who received allogeneic HSCT from 2000 to 2009 for standard-risk leukemia and achieved disease-free survival up to 3 months after allogeneic HSCT were included. From participating centers, 145 patients were enrolled. Median age was 46 years (19-68). Patients were classified based on weight loss during 3 months after allogeneic HSCT as follows: normal group (weight loss o 5%, n = 53), mild malnutrition group (5% ⩽ weight loss o 10%, n = 47), severe malnutrition group (10% ⩽ weight loss, n = 45). The cumulative incidences of 2-year nonrelapse mortality (NRM) were 3.8% in the normal group, 8.5% in the mild malnutrition group and 27.3% in the severe malnutrition group. The probabilities of a 2-year OS were 73.2% in the normal group, 74.5% in the mild malnutrition group and 55.3% in the severe malnutrition group. In multivariate analysis, severe malnutrition was associated with an increased risk of NRM and a worse OS. In conclusion, weight loss ⩾ 10% was associated with a worse clinical outcome. Prospective studies that identify patients at risk of malnutrition and intervention by a nutritional support team are warranted.

Systematic Nutritional Support in Allogeneic Hematopoietic Stem Cell Transplant Recipients

“…Our group reported that severe weight loss ( 10% weight loss in 3 months) after allogeneic HSCT was associated with an increased risk of subsequent NRM, which led to a poor overall survival [38]. Bassim et al also reported that patients with malnutrition had inferior outcomes compared with those without malnutrition.…”

“…Regarding undernutrition, weight loss is rather common after allogeneic HSCT [38,[87][88][89][90][91][92][93]. Our group reported that severe weight loss ( 10% weight loss in 3 months) after allogeneic HSCT was associated with an increased risk of subsequent NRM, which led to a poor overall survival [38].…”

Association of Nutritional Parameters with Clinical Outcomes in Patients with Acute Myeloid Leukemia Undergoing Haematopoietic Stem Cell Transplantation

“…Our data are in line with previous studies looking at associations of nutritional parameters and outcomes in patients with haematological malignancies. One recent retrospective study from Japan including 145 adult patients who received allogeneic HSCT from 2000 to 2009 reported a step-wise increase in the cumulative incidences of 2-year non-relapse mortality from 3.8% in the normal group up to 27.3% in the severe malnutrition group defined based on the post-HSCT weight loss of >10% [28] . The same researchers also found that underweight patients before HSCT was a risk factor for mortality with a roughly 10% increase in risk [29] .…”

Survivorship - lebenslange Begleitung von Krebspatienten

“…Negative Auswirkungen eines raschen Gewichtsverlusts auf die Mortalität sind etwa für Patienten nach allogener Stammzelltransplantation belegt [20]. …”