Nutritional assessment as predictor of complications after hematopoietic stem cell transplantation

Abstract

IntroductionNutritional support is pivotal in patients submitted to hematopoietic stem cell transplantation. Nutritional status has been associated with time of engraftment and infection rates. In order to evaluate the association between nutritional parameters and clinical outcomes after transplantation a cohort of transplant patients was retrospectively evaluated.MethodsAll 50 patients transplanted between 2011 and 2014 were included. The nutritional status before transplantation, ten days after transplantation and before discharge was assessed including anthropometry, body mass index, albumin, prealbumin and total urinary nitrogen.ResultsThe median follow-up time was 41 months and the median age of patients was 41 years. Thirty-two underwent allogeneic and 18 autologous transplants. Diagnoses included acute leukemias (n = 27), lymphoma (n = 7), multiple myeloma (n = 13), and aplastic anemia (n = 3). Thirty-seven patients developed mucositis (three Grade 1, 15 Grade 2, 18 Grade 3 and one Grade 4), and twenty-two allogeneic, and five autologous transplant patients required total parenteral nutrition. Albumin and total urinary nitrogen were associated with length of hospital stay and platelet and neutrophil engraftment. None of the nutritional parameters evaluated were associated with overall survival. Non-relapse mortality was 14% and overall survival was 79% at 41 months of follow-up.ConclusionsAfter hematopoietic stem cell transplantation, high catabolism was associated with longer length of hospital stay, the need of total parenteral nutrition and platelet and neutrophil engraftment times. Nutritional parameters were not associated with overall survival.

Revisiting nutritional support for allogeneic hematologic stem cell transplantation—a systematic review

“…Yet, high catabolism, expressed by laboratory parameters as albumin or nitrogen balance, was associated with longer hospital stay. 72 Our own retrospective study did as well show a correlation of high weight loss during the index hospitalization and increased morbidity and length of hospital stay. 73 However, we also found an association of low pretransplantation body weight with mortality.…”

“…Therefore, we did not fully integrate them into our work. A retrospective analysis by Espinoza et al 72 did not show a correlation of nutritional parameters with survival. Yet, high catabolism, expressed by laboratory parameters as albumin or nitrogen balance, was associated with longer hospital stay.…”

<p>Hematological Abnormalities and Associated Factors Among Undernourished Under-Five Children Attending University of Gondar Specialized Referral Hospital, Northwest Ethiopia</p>

“…24,25 Leukopenia and leukocytosis that occurs in PEM as a result of an infection by establishing a malnutrition-infection relationship in which the poor nutritional status disrupts leukopoiesis. 26 The occurrence of leukocytosis in PEM is usually accompanied by infectious processes or chronic disease. 9,27 Leukopenia is present in children with PEM if they are not accompanied by other diseases.…”

Serum electrolyte dynamics in multiple myeloma patients undergoing autologous haematopoietic stem cell transplantation

“…It is worthwhile to note amifostine pretreatment was utilized as a routine practice for MM patients who receive transplant in our centre. Previously, our group and others showed impact of this agent in reducing GI toxicities associated with HCT . Although amifositine potentially can ameliorate some of the electrolyte abnormalities due to lower frequency of GI toxicities and potential GI loss or renal loss, giving amifostine does not impact the engraftment dynamics.…”