Comprehensive evaluation of nutritional status before and after hematopoietic stem cell transplantation in 170 patients with hematological diseases

Abstract

ObjectiveTo investigate the nutritional status of patients before and after hematopoietic stem cell transplantation (HSCT), and explore optimal methods for assessing nutritional status in patients with hematological diseases.MethodsThis cohort study enrolled 170 patients who were diagnosed with hematological diseases and underwent allogeneic HSCT in the Department of Hematology, Peking University People’s Hospital between May 2011 and April 2013. We used fixed-point continuous sampling and four nutritional screening tools, Nutritional Risk Screening 2002 (NRS-2002), Mini Nutritional Assessment (MNA), Subjective Global Assessment (SGA) and Malnutrition Universal Screening Tools (MUST), in combination with body measurements, to extensively screen and evaluate nutritional risks and status in patients receiving HSCT before entering and after leaving laminar air flow rooms.ResultsAfter HSCT, patients had significant reduction in weight, hip circumference, waist-hip ratio, calf circumference, mid-upper arm circumference, and suprailiac skinfold thickness compared with pre-HSCT measurements. Before HSCT, NRS-2002 identified that 21.2% of patients were at nutritional risks, compared with 100% after HSCT. MUST indicated that before HSCT, 11.77% of patients were at high nutritional risk, compared with 59.63% after HSCT. MNA assessed that 0.06% of patients were malnourished before HSCT, compared with 19.27% after HSCT. SGA identified that before HSCT, 1.76% of patients had mild to severe malnutrition, which increased to 83.3% after HSCT. There is a significant increase in the nutritional risk and malnutrition in patients who received HSCT.ConclusionsBefore HSCT, some patients already had nutritional risk or nutritional deficiencies, and prompt and close nutritional screening or assessment should be performed. The nutritional status of patients after HSCT was generally deteriorated compared with that before transplantation. Body measurements should be taken more frequently during the subsequent treatment window in the laminar air flow rooms. After HSCT, it is recommended to combine MNA and SGA to fully evaluate the nutritional status, and thus provide timely and reasonable nutritional support.

Evaluation of nutritional risk factors in hematopoietic stem cell transplantation-eligible patients

“…Mean WC (91.6±11.4cm; CVD risk) was in keeping with values reported elsewhere (mean WC, 96.8±6.9cm in HSCT-eligible patients). (19) Sarcopenia was the most prevalent nutritional condition in patients in this sample (62.5% overall and 48.6% of patients with self-reported changes in functional capacity). Similar findings have been reported in a different study (sarcopenia and significantly reduced functional capacity in 50.6% of patients scheduled for HSCT; p=0.022).…”

Enteral nutrition protects children undergoing allogeneic hematopoietic stem cell transplantation from blood stream infections

“…Oral feeding in the early post-transplant period is impaired because of conditioning regimen-side effects, mainly vomiting, anorexia, diarrhoea and mucositis. The reduction in caloric intake gives rise to a rapid deterioration of the nutritional status [5][6][7] which is associated with lower overall survival as well as higher complication rates during treatment [8][9][10].…”

Cardiovascular risk and use of conicity index in patients submitted to autologous hematopoietic stem cell transplantation

“…Additionally, this anthropometric measurement is a simple and effective method to check total and intraabdominal fat. ( 22 ) Liu et al , ( 23 ) investigated the nutritional status of Chinese patients before and after HSCT, and in the pre-transplant period, a mean WC of 84.9cm was measured and presented low risk for obesity-related diseases. Whereas in the study by Bhansali et al, ( 24 ) which evaluated patients submitted to autologous HSCT in India, an increased mean WC (103cm) was noted, and the value was higher to that found in the present study (96.83cm).…”