Increase in height during the first year after bone marrow transplantation reflecting nutritional status of children

Abstract

Summary:We studied the influence of pre-transplant nutritional status on height velocity during the first post-transplant year. Thirty-seven children aged 1.4-12.4 years, 19 males and 18 females, underwent bone marrow transplantation (24 allogeneic, 13 autologous) with fractionated total body irradiation included in the preparative regimen of 25. The underlying diagnoses were leukemia (n = 16), malignant solid tumor (n = 11), and non-malignant hematologic or metabolic disease (n = 10). The serum concentrations of albumin, pre-albumin and transferrin were measured. Anthropometric measurements included weight, mid-arm circumference (MAC) and triceps skinfold thickness, expressed as percentages of the age-and sex-specific standards. The skeletal muscle protein reserve was estimated as muscle index (MI) by ultrasonographic imaging of the femoral quadriceps muscle. Height velocity was expressed as a standard deviation score (SDS) of the age-and sex-specific mean. The mean relative height velocity SDS was −1.6 (95% CI −2.2-−1.0). Height velocity correlated significantly with pre-transplant MI (r = 0.54, P = 0.004), concentration of serum transferrin (r = 0.33, P = 0.05) and MAC (r = 0.45, P = 0.04). Our data suggest that pretransplant nutritional status has an impact on growth in height during the post-transplant period.

Final height and gonad function after total body irradiation during childhood

“…21 Taskinen and Saarinen-Pihkala 22 showed that the nutritional status before TBI, evaluated by muscle index, mid-arm circumference and serum transferin concentration, was positively correlated with the growth rate during the first year after TBI. We compared the increases in centimeters to increases in kilograms during pubertal growth and found a positive correlation.…”

Endocrine late effects after bone marrow transplant

“…This was complicated by persistently low body mass index (BMI) and low leptin levels, leading the authors to imply that poor nutrition may be a factor and that nutritional support in addition to GH replacement may optimize the growth rate of these patients (Couto‐Silva et al , 2000). Taskinen & Saarinen‐Pihkala (1998) also suggested that nutritional status, in particular pretransplant, had an impact on height velocity in the post‐transplant period, with those patients with the poorest nutritional status having the worst post‐transplant growth.…”

Growth Patterns and Gastrointestinal Symptoms in Pediatric Patients After Hematopoietic Stem Cell Transplantation

“…Few studies of mid-arm circumference and skinfold triceps changes in pediatric patients after HscT exist. Taskinen and saarinen-Pihkala (1998), evaluating mid-arm circumference and skinfold thickness in relation to height velocity in 42 pediatric patients during the first year after HscT, found that height velocity strongly correlated with mid-arm circumference (r = 0.45, p = 0.04) and height velocity moderately correlated with skinfold triceps measurements (r = 0.36, p = 0.1), validating the effectiveness of using mid-arm circumference and skinfold triceps measurements to assess growth changes in pediatric patients. nausea, vomiting, diarrhea, mucositis, and anorexia are well-known gi side effects of HscT conditioning regimens; however, only one study has evaluated gi symptoms in pediatric patients after discharge from HscT.…”