The impact of pretransplant malnutrition on allogeneic hematopoietic stem cell transplantation outcomes

SummaryBackgroundMalnutrition is a common finding in allogeneic hematopoietic stem cell transplantation (alloHSCT) patients, and there is some evidence that malnutrition might negatively affect the transplant outcomes. MethodWe performed a retrospective study with 148 patients aged 18–75 years, who...

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Published in:	Clinical nutrition ESPEN Vol. 33; pp. 213 - 219
Main Authors:	Hirose, Erika Yuri, de Molla, Vinicius Campos, Gonçalves, Matheus Vescovi, Pereira, André Domingues, Szor, Roberta Shcolnik, da Fonseca, Ana Rita Brito Medeiro, Fatobene, Giancarlo, Serpa, Mariana Gomes, Xavier, Erick Menezes, Tucunduva, Luciana, Rocha, Vanderson, Novis, Yana, Arrais-Rodrigues, Celso
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 01-10-2019
Subjects:	Allogeneic hematopoietic stem cell transplantation Gastroenterology and Hepatology Graft-versus-host disease Malnutrition Subjective global assessment Survival Graft-versus-host disease Allogeneic hematopoietic stem cell transplantation Subjective global assessment Malnutrition Survival
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Summary:	SummaryBackgroundMalnutrition is a common finding in allogeneic hematopoietic stem cell transplantation (alloHSCT) patients, and there is some evidence that malnutrition might negatively affect the transplant outcomes. MethodWe performed a retrospective study with 148 patients aged 18–75 years, who underwent alloHSCT between 2011 and 2017. Patients were classified according to the body mass index (BMI) and the Subjective Global Assessment (SGA). The SGA was assessed on the day of hospitalization for the transplant, and classifies patients into three groups: A (well-nourished), B (moderately malnourished) and C (severely malnourished). ResultsThe SGA classified 49 (33%) patients as well-nourished, 54 (37%) as moderately malnourished, and 45 (30%) as severely malnourished. SGA-C was also associated with severe acute graft versus host disease (aGVHD) with a cumulative incidence (CI) of 31% vs. a CI of 14% for combined well-nourished or moderately malnourished group (SGA-A or –B, P = 0.017). In multivariate analysis, SGA-C compared to SGA-A or –B, remained as an independent risk factor for aGVHD (hazard ratio - HR 1.68, 95% confidence interval - 95% CI 1.02–2.74), and nonrelapse mortality (NRM - HR 3.63, 95% CI 1.76–7.46), worse progression free survival (HR 2.12, 95% CI 1.25–3.60), and worse overall survival (HR 3.27, 95% CI 1.90–5.64). ConclusionMalnutrition increases the risk of aGVHD and NRM and has a negative impact on survival.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2405-4577 2405-4577
DOI:	10.1016/j.clnesp.2019.05.005