Pre-transplant arm muscle area: a simple measure to identify patients at risk
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This study aims to explore parameters of nutritional assessment and food intake as predictors of clinical outcomes after hematopoietic stem cell transplant (HSCT).
The study was conducted retrospectively with 56 adult patients undergoing allogeneic HSCT. Energy and protein daily intake were used to calculate the energy and protein cumulative deficit. The nutritional assessment tools were weight, body mass index (BMI), triceps skinfold (TSF), and arm muscle area (AMA) before HSCT and after HSCT.
Food intake decreased immediately after the transplant and the energy and protein cumulative deficit increased during hospitalization (p < 0.01). Almost 70 % of patients had severe weight loss (greater than 5 %), and the average percentage of weight loss was 8.5 ± 3.9 %. BMI and weight loss percentage were not correlated with the presence of acute graft versus host disease (GVHD) and mortality within 180 days in this population. On the other hand, correlation was found between the initial (pre-HSCT) AMA equal to or below the 15th percentile, with the presence of acute GVHD (p = 0.024), and mortality within 180 days after HSCT (p = 0.010).
The AMA measured pre-HSCT showed to be a potential predictor of acute GVHD and mortality up to 180 days after transplant in adult patients.
KeywordsNutritional assessment Body composition Food intake Hematopoietic stem cell transplantation
The first author was sponsored scholarships by the Ministry of Education (MEC), Brasília, DF, and Hospital de Clínicas, Federal University of Paraná.
The authors thank the Accredited Multiprofessional Residency, the Nutrition and Dietetic Unit and the Bone Marrow Transplant Unit at the teaching hospital of Federal University of Paraná, as well as and the Department of Nutrition at Federal University of Paraná. The authors also thank Heliz Alves das Neves for her technical support with the patients’ database.
Compliance with ethical standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.
Conflict of interest
The authors declare that they have no competing interests.
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