Longitudinal follow-up of body composition in hematopoietic stem cell transplant patients

• Published in: Bone marrow transplantation (Basingstoke) Vol. 35; no. 12; pp. 1171 - 1177
• Main Authors: KYLE, U. G, CHALANDON, Y, MIRALBELL, R, KARSEGARD, V. L, HANS, D, TROMBETTI, A, RIZZOLI, R, HELG, C, PICHARD, C
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01-06-2005
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Body Composition; Body mass; Body mass index; Body size; Bone marrow; Bone Marrow Transplantation - adverse effects; Bone marrow, stem cells transplantation. Graft versus host reaction; Case-Control Studies; Complications; Confidence intervals; Graft vs Host Disease; Graft-versus-host reaction; Health aspects; Hematologic Neoplasms - complications; Hematologic Neoplasms - metabolism; Hematologic Neoplasms - therapy; Hematopoietic Stem Cell Transplantation - adverse effects; Hematopoietic stem cells; Humans; Karnofsky Performance Status; Lean body mass; Longitudinal Studies; Measurement; Medical sciences; Odds Ratio; Organ transplant recipients; Patients; Physiological aspects; Regression analysis; Retrospective Studies; Statistical analysis; Stem cell transplantation; Stem cells; Steroids - adverse effects; Steroids - therapeutic use; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation; Transplantation, Homologous; Transplants & implants; Switzerland; Human; Hematology; Follow up study; Stem cell; Hematopoietic cell; Lean body mass; Graft; Patient; fat-free mass; longitudinal follow-up; Fat mass; Body composition
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/sj.bmt.1704996

Patients with hematological malignancies are well nourished prior to allogeneic hematopoietic stem cell transplantation (HSCT). HSCT and associated complications can affect body composition. The study evaluated cross-sectionally the prevalence and longitudinally the changes in lean body mass index (LBMI) in HSCT patients. Patients (n=82) were classified as normal or low LBMI. Logistic regression analyses were used to estimate odds ratios (OR) for low vs normal LBMI, between healthy volunteers and patients; for limited or extensive vs no chronic graft-versus-host-disease (GVHD); and for decreased (Karnofsky <80) vs normal functional status (>80). Patients were significantly more likely to have low LBMI at 6, 12 months, 2-3, 4-6 and >6 years than volunteers. In all, 38% of patients were below pre-HSCT LBMI at 4-6 years post-HSCT. Low LBMI was significantly associated with steroid treatment (OR 2.6, confidence intervals (CI) 1.3-5.2, P=0.008); limited (OR 5.5, CI 1.7-18.5, P=0.005) or extensive chronic GVHD (OR 20.3, CI 5.7-71.6, P<0.001); and decreased performance status (Karnofsky scores of < or =80) (OR 2.7, CI 1.3-5.9, P=0.01). Patients were more likely to have low LBMI than volunteers. Chronic GVHD and low performance status were associated with low LBMI; thus, complications and/or treatment increase the likelihood of low LBMI.