Clin Nutr Res.  2012 Jul;1(1):3-12. 10.7762/cnr.2012.1.1.3.

Nutritional Intake and Nutritional Status by the Type of Hematopoietic Stem Cell Transplantation

• So EJ
• Lee JS
• Kim JY

• KMID: 2279747
• DOI: http://doi.org/10.7762/cnr.2012.1.1.3

Abstract

The aim of this study was to investigate the changes of nutritional intake and nutritional status and analyze the association between them during hematopoietic stem cell transplantation. This was a retrospective cross sectional study on 36 patients (9 Autologous transplantation group and 27 Allogeneic transplantation group) undergoing hematopoietic stem cell transplantation at The Catholic University of Korea, Seoul St. Mary's Hospital from May to August 2010. To assess oral intake and parenteral nutrition intake, 24-hour recall method and patient's charts review was performed. Nutritional status was measured with the scored patient-generated subjective global assessment (PG-SGA). The subjects consisted of 6 (66.7%) males and 3 (33.3%) females in the autologous transplantation group (auto), 12 (44.4%) males and 15 (55.6%) females in the allogeneic transplantation group (allo). The mean age was 40.9 +/- 13.6 years (auto) and 37.8 +/- 11.0 years (allo). The average hospitalized period was 25.2 +/- 3.5 days (auto) and 31.6 +/- 6.6 days (allo), which were significant different (p < 0.05). Nutritional intake was lowest at Post+1wk in two groups. In addition, calorie intake by oral diet to recommended intake at Post+2wk was low (20.8% auto and 20.5% allo) but there were no significant differences in change of nutritional intake over time (Admission, Pre-1day, Post+1wk, Post+2wk) between auto group and allo group by repeated measures ANOVA test. The result of nutritional assessment through PG-SGA was significantly different at Pre-1day only (p < 0.01). There was a significant negative correlation between the nutritional status during Post+2wk and the oral calorie/protein intake to recommended amount measured during Post+1wk and Post+2wk (p < 0.01). These results could be used to establish evidence-based nutritional care guidelines for patients during hematopoietic stem cell transplantation.

Keyword

Diet; Hematopoietic stem cell transplantation; Leukemia; Nutritional status

MeSH Terms

Diet
Female
Hematopoietic Stem Cell Transplantation*
Hematopoietic Stem Cells*
Humans
Korea
Leukemia
Male
Nutrition Assessment
Nutritional Status*
Parenteral Nutrition
Retrospective Studies
Seoul
Transplantation, Autologous
Transplantation, Homologous

Reference

1. Kim HK, Cho B, Chung NG, Jeong DC, Jang PS, Kim SY, Kim CC. Two hundred cases of allogeneic hematopoietic stem cell transplantation in children: single center study. Korean J Hematop Stem Cell Transplant. 2002. 7:63–71.

2. Min WS. Bone marrow transplantation. Korean J Crit Care Med. 2001. 16:17–22.

3. Trigg ME, Inverso DM. Nausea and vomiting with high-dose chemotherapy and stem cell rescue therapy: a review of antiemetic regimens. Bone Marrow Transplant. 2008. 42:501–506.

4. Seong JM. Dr.Seong's leukemia clinic. 2005. Seoul: Koonja Publishing Inc..

5. Kim NC, Kim HS, Choi SE, Park HJ. Nutritional status of recipients of allogenetic hematopoietic stem cell transplantation by types of conditioning regimen. J Korea Community Health Nurs Acad Soc. 2000. 14:191–202.

6. Kim HJ, Noh MY, Jung MJ, Hong JI, Jung YS. A study of the factors affecting the term of engraftment during hematopoietic stem cell transplantation with a focus on the inhibitors of oral intake and the period of nutritional support. J Korean Diet Assoc. 2009. 15:168–178.

7. Barker CC, Anderson RA, Sauve RS, Butzner JD. GI complications in pediatric patients post-BMT. Bone Marrow Transplant. 2005. 36:51–58.

8. Mattsson J, Westin S, Edlund S, Remberger M. Poor oral nutrition after allogeneic stem cell transplantation correlates significantly with severe graft-versus-host disease. Bone Marrow Transplant. 2006. 38:629–633.

9. Attar A, Malka D, Sabaté JM, Bonnetain F, Lecomte T, Aparicio T, Locher C, Laharie D, Ezenfis J, Taieb J. Malnutrition is high and underestimated during chemotherapy in gastrointestinal cancer: an AGEO prospective cross-sectional multicenter study. Nutr Cancer. 2012. 64:535–542.

10. Norman K, Pichard C, Lochs H, Pirlich M. Prognostic impact of disease-related malnutrition. Clin Nutr. 2008. 27:5–15.

11. Schneider SM, Veyres P, Pivot X, Soummer AM, Jambou P, Filippi J, van Obberghen E, Hébuterne X. Malnutrition is an independent factor associated with nosocomial infections. Br J Nutr. 2004. 92:105–111.

12. Amaral TF, Matos LC, Tavares MM, Subtil A, Martins R, Nazaré M, Sousa Pereira N. The economic impact of disease-related malnutrition at hospital admission. Clin Nutr. 2007. 26:778–784.

13. Correia MI, Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr. 2003. 22:235–239.

14. Choi K, Kim HJ, Cho HJ, Choe YG, Lee DY, Park SK, Koh YL, Oh SJ, Lee SS. Assessment of nutritional status and prognosis in advanced metastatic cancer. Korean J Med. 2006. 71:132–140.

15. Schaible UE, Kaufmann SH. Malnutrition and infection: complex mechanism and global impacts. PLoS Med. 2007. 4:e115.

16. Horsley P, Bauer J, Gallagher B. Poor nutritional status prior to peripheral blood stem cell transplantation is associated with increased length of hospital stay. Bone Marrow Transplant. 2005. 35:1113–1116.

17. Deeg HJ, Seidel K, Bruemmer B, Pepe MS, Appelbaum FR. Impact of patient weight on non-relapse mortality after marrow transplantation. Bone Marrow Transplant. 1995. 15:461–468.

18. Le Blanc K, Ringdén O, Remberger M. A low body mass index is correlated with poor survival after allogeneic stem cell transplantation. Haematologica. 2003. 88:1044–1052.

19. Iestra JA, FIbbe WE, Zwinderman AH, Romijn JA, Kromhout D. Parenteral nutrition following intensive cytotoxic therapy: an exploratory study on the need for parenteral nutrition after various treatment approaches for haematological malignancies. Bone Marrow Transplant. 1999. 23:933–939.

20. Duggan C, Bechard L, Donovan K, Vangel M, O'Leary A, Holmes C, Lehmann L, Guinan E. Changes in resting energy expenditure among children undergoing allogeneic stem cell transplantation. Am J Clin Nutr. 2003. 78:104–109.

21. Pedrón C, Madero L, Madero R, García-Novo MD, Díaz MA, Hernández M. Short-term follow-up of the nutritional status of children undergoing autologous peripheral blood stem cell transplantation. Pediatr Hematol Oncol. 2000. 17:559–566.

22. Roberts S, Miller J, Pineiro L, Jennings L. Total parenteral nutrition vs oral diet in autologous hematopoietic cell transplant recipients. Bone Marrow Transplant. 2003. 32:715–721.

23. Rzepecki P, Brazal J, Sarosiek T, Szczylik C. Biochemical indices for the assessment of nutritional status during hematopoietic stem cell transplantation: are they worth using? A single center experience. Bone Marrow Transplant. 2007. 40:567–572.

24. Arfons LM, Lazarus HM. Total parenteral nutrition and hematopoietic stem cell transplantation: an expensive placebo? Bone Marrow Transplant. 2005. 36:281–288.

25. Lee J, Lee MH, Park KW, Kang JH, Im DH, Kim K, Lee SH, Kim WS, Park J, Jung CW, Parka K. Influential factors for the collection of peripheral blood stem cells and engraftment in acute myeloid leukemia patients in first complete remission. Int J Hematol. 2005. 81:258–263.

26. Ergene U, Cağirgan S, Pehlivan M, Yilmaz M, Tombuloğlu M. Factors influencing engraftment in autologous peripheral hematopoietic stem cell transplantation(PBSCT). Transfus Apher Sci. 2007. 36:23–29.

27. Hong JI, Chang UJ. The relationship between the period of engraftment and the nutritional status in patients undergoing allogenic bone marrow transplantation for acute myelogenous leukemia. Korean J Community Nutr. 2002. 7:578–584.

28. Kim KJ. Manual of medical nutrition therapy. 2008. 3rd ed. Seoul: The Korean Dietetic Association.

29. Bauer J, Capra S, Ferguson M. Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr. 2002. 56:779–785.

30. Isenring E, Bauer J, Capra S. The scored patient-generated subjective global assessment (PG-SGA) and its association with quality of life in ambulatory patients receiving radiotherapy. Eur J Clin Nutr. 2003. 57:305–309.

31. Muscaritoli M, Grieco G, Capria S, Iori AP, Rossi Fanelli F. Nutritional and metabolic support in patients undergoing bone marrow transplantation. Am J Clin Nutr. 2002. 75:183–190.

32. Hadjibabaie M, Iranvani M, Taghizadeh M, Ataie-Jafari A, Shamshiri AR, Mousavi SA, Alimoghaddam K, Hosseini S, Ghavamzadeh A. Evaluation of nutritional status in patients undergoing hematopoietic SCT. Bone Marrow Transplant. 2008. 42:469–473.

33. Kim WG, Park MS, Lee YH, Heo DS. Nutritional risk in oncology outpatients receiving chemotherapy. Korean J Community Nutr. 2008. 13:573–581.

34. Yang YH, Lee DS. The relationship of anorexia, nausea, vomiting, oral intake and nutritional status in patients receiving chemotherapy. J Korean Acad Nurs. 2000. 30:720–730.

35. Yang YH, Kwon SJ, Kim CI. The nutritional status of the patients with cancer during the chemotherapies. J Korean Acad Nurs. 2001. 31:978–987.

36. Iestra JA, Fibbe WE, Zwinderman AH, van Staveren WA, Kromhout D. Body weight recovery, eating difficulties and compliance with dietary advice in the first year after stem cell transplantation: a prospective study. Bone Marrow Transplant. 2002. 29:417–424.

37. Boer CC, Correa ME, Miranda EC, de Souza CA. Taste disorders and oral evaluation in patients undergoing allogeneic hematopoietic SCT. Bone Marrow Transplant. 2010. 45:705–711.

38. Epstein JB, Phillips N, Parry J, Epstein MS, Nevill T, Stevenson-Moore P. Quality of life, taste, olfactory and oral function following high-dose chemotherapy and allogeneic hematopoietic cell transplantation. Bone Marrow Transplant. 2002. 30:785–792.

39. Iversen PO, Wisløff F, Gulbrandsen N. Reduced nutritional status among multiple myeloma patients during treatment with high-dose chemotherapy and autologous stem cell support. Clin Nutr. 2010. 29:488–491.

40. Browning B, Thormann K, Seshadri R, Duerst R, Kletzel M, Jacobsohn DA. Weight loss and reduced body mass index: a critical issue in children with multiorgan chronic graft-versus-host disease. Bone Marrow Transplant. 2006. 37:527–533.

41. Jacobsohn DA, Margolis J, Doherty J, Anders V, Vogelsang GB. Weight loss and malnutrition in patients with chronic graft-versus-host disease. Bone Marrow Transplant. 2002. 29:231–236.