The aim of the present study was to assess the influence of socioeconomic status (SeS) on the outcome of allo-SCT at a Brazilian SCT center. In total, 201 patients receiving HLA-identical related allo-SCTs were studied. The median age was 30 years. Overall, 163 patients had malignancies (CML 68, ALL/AML 63, myelodysplastic syndrome 12 and others 20). SeS was defined according to the Brazilian Association of Market Research Agencies classification, where people are clustered in groups A-E (richest to poorest). In total, 146 patients (72%) were classified as richest (A+B+C) and 55 (28%) as poorest (D+E). The D+E SeS group was associated with a higher incidence of chronic GVHD and acute GVHD (hazard ratio (HR)=2.61; P=0.001 and HR=2.62; P=0.001, respectively), better platelet and neutrophil engraftment (HR=1.94; P=<0.001 and HR=2.12; P=0.001) and with a higher TRM in multivariate analysis (HR=1.92; P=0.039). Estimated overall survival at 5 years was 55.2%. A D+E SeS (HR=2.13; P=0.001) was associated with a worse survival on multivariate analysis. In conclusion, a lower SeS is a strong prognostic factor in patients undergoing allo-SCT in Brazil, influencing engraftment, TRM and overall survival.

Background: The development of nutrition care programs for patients undergoing hematopoietic stem cell transplantation is necessity in view of the rapid and aggressive consequences frequently seen with this procedure. Patients require constant care to reduce complications and to contribute to the success of therapy. Methods: In an attempt to ascertain the impact of systematic nutritional care on patients submitted to allogeneic hematopoietic stem cell transplantation, the present study assessed the nutritional and clinical status, use of parenteral nutrition, and complication and mortality rates in two groups of patients, who were submitted to transplantation between April 2003 and December 2004 (Non-intervention Group - NIG; n = 57) and between March 2006 and January 2008 (Intervention Group - IG; n = 34). Results: There were no significant differences between groups in terms of clinical or nutritional profiles. Additionally, the length of hospital stay and complication and mortality rates were similar for both groups. However, time on parenteral nutrition during treatment was shorter for the IG [median 6.5 days (range: 1-28) for related donor recipients and 11 days (range: 1-21) for unrelated donor recipients] than for the NIG [median 20.5 days (range, 4-73) for patients submitted to myeloablative conditioning and 18.5 days (range: 11-59 days) for those submitted to nonablative conditioning]. Conclusion: The implementation of a nutritional follow-up and therapy protocol for adult patients submitted to hematopoietic stem cell transplantation shortens the duration of parenteral nutrition. It certainly has an impact on hospitalization costs and, potentially, on the rate of complications, even though this was not demonstrated in this study.

4Pacientes submetidos a transplante de células-tronco hematopoéticas alogênico (TCTH alo)

A dietoterapia é essencial para pacientes hospitalizados. O objetivo deste estudo foi avaliar a aceitabilidade das refeições do almoço de pacientes que receberam a dietética para Diabetes Mellitus (DM) e verificar aspectos que podem interferir nesse consumo, como as estações do ano. Estudo quantitativo descritivo que avaliou o consumo da refeição almoço dos pacientes que receberam dietética DM em um período de verão e outro de inverno no ano de 2019. Os dados foram verificados em frequências absolutas, porcentagens, médias, e o teste estatístico foi o de regressão logística com a correlação de dados a um nível de significância de 95% (p <0,05) usando o software SPSS® 18.0. Foram selecionadas duas unidades de internação, com amostra de 49 indivíduos (63,3% do sexo masculino). Das 115 refeições servidas, 55,7% foram parcialmente consumidas ou não consumidas. O desperdício de pratos nas refeições do almoço apresentou média per capita de 64,15 g (consumo de 310,89g) no verão e de 135,99g (consumo de 248,12g) no inverno. O padrão do cardápio foi semelhante nas duas estações. Encontrou-se p <0,05 em relação à temporada na associação do odds ratio univariável. Pesquisas dessa natureza são importantes para auxiliar no prognóstico do paciente.

Introducción y objetivos. Identificar y analizar las necesidades de atención de los pacientes candidatos a trasplante de células tronco hematopoyéticas (TCTH) con el fin de planificar las intervenciones para cada situación específica en el Programa Asistencial de Trasplante de Células Tronco Hematopoyéticas (PATCTH).

No abstract

Nutritional care in onco-hematologic patients should be part of the overall treatment of the patient. Disturbances resulting from tumor localization, especially in tumors of the digestive tract, and their treatments like chemotherapy and radiotherapy and side effects of surgery often prevent oral feeding. This can lead to malnutrition and it is of great importance detection, assessment and intervention.

Objective Describe the dietary intake of children and adolescents submitted to allogeneic hematopoietic stem cell transplantation. Methods Data from 0 to 19-year-old patients’ medical records who were submitted to the procedure from January 2012 to September 2017 were used. These medical records provided anthropometric, food intake control and symptoms data for three moments: three days before infusion (M1), the infusion day (M2), and 25 days after the cell infusion (M3). This study was approved by the Ethics in Research Committee (17-0267). Results The patients presented weight loss (p>0.001) and a decrease in body mass index (p>0.001) in M1 versus M2 and M3. The means of calorie intake (p=0.031), protein (p=0.006), lipid (p=0.017), dietary fiber (p=0.035), calcium (p=0.005), iron (p=0.012), and sodium (p=0.022) had a reduction from M1 to M2 and an increase from M2 to M3. There was a decrease in mean intake of carbohydrates and calories per kilo from M1 to M2 and an increase from M2 to M3. The nutritional status was related to temperature above 37ºC (p<0.001) and to mucositis (p=0.001), in M1 and M2. There was a correlation of dietary intake with the presence of temperature above 37ºC (p=0.019) in M2 and M3. Conclusion Reduced intake and worsening of the patients’ previous nutritional status appear to interfere with allogeneic hematopoietic stem cell transplantation and its complications, such as the presence of temperature above 37ºC and mucositis.