Skip to main content

Advertisement

SpringerLink
Log in

Nutritional issues and body weight in long-term survivors of allogeneic blood and marrow transplant (BMT) in NSW Australia

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

The aims of this study were to describe the long-term nutrition, body weight and body image issues facing survivors of Allogeneic Blood and Marrow Transplant (BMT) and their impact on quality of life. It also describes survivors’ perception of enteral feeding during BMT.

Methods

Four hundred and forty-one survivors who had undergone a BMT in NSW, Australia between 2000 and 2012 (n = 441/583) completed the Sydney Post BMT Study Survey (SPBS).

Results

Forty-five percent of survivors less than 2-year post-transplant reported a dry mouth, 36 % reported mouth ulcers and 19 % had diarrhoea. This was consistent across all survivor groups, regardless of time since transplant. Patients with one or more gastrointestinal (GI) symptoms had significantly lower quality of life scores. There was a significant difference in quality of life scores when comparing those with no GI symptoms to those with one or more symptoms (P = <0.0001). Quality of life was significantly higher in those who once again enjoyed mealtimes (P < 0.0001). Males were more likely to be satisfied with their body weight compared to females (P = 0.009). The median body mass index (BMI) for all patients reporting body weight satisfaction was significantly lower (BMI 23.5) than those reporting dissatisfaction (BMI 27.5) (P = <0.0001). Survivors who had a normal BMI had significantly higher rates of body weight satisfaction compared to underweight, overweight and obese survivors (P = <0.0001). Those survivors who were overweight or obese were significantly more likely to be diabetic (P = 0.008).

Conclusion

This study revealed an important relationship between gastrointestinal symptoms, body weight and body image and survivor’s quality of life. It provides further support for the importance of nutrition therapy post-BMT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Gifford G, Sim J, Horne A, Ma D (2014) Health status, late effects and long-term survivorship of allogeneic bone marrow transplantation: a retrospective study. Intern Med J 44(2):139–147

    Article  CAS  PubMed  Google Scholar 

  2. Savani BN, Griffith ML, Jagasia S, Lee SJ (2011) How I treat late effects in adults after allogeneic stem cell transplantation. Blood 117(11):3002–3009

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Nivison-Smith I, Bardy P, Dodds AJ, Ma DD, Aarons D, Tran S, et al. (2016) A review of hematopoietic cell transplantation in Australia and New Zealand, 2005 to 2013. Biol Blood Marrow Transplant. 22(2):284–291

    Article  PubMed  Google Scholar 

  4. Majhail NS, Farnia SH, Carpenter PA, Champlin RE, Crawford S, Marks DI, et al. (2015) Indications for autologous and allogeneic hematopoietic cell transplantation: guidelines from the American Society for Blood and Marrow Transplantation. Biol Blood Marrow Transplant. 21(11):1863–1869

    Article  PubMed  PubMed Central  Google Scholar 

  5. Armenian SH, Sun CL, Vase T, Ness KK, Blum E, Francisco L, et al. (2012) Cardiovascular risk factors in hematopoietic cell transplantation survivors: role in development of subsequent cardiovascular disease. Blood 120(23):4505–4512

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Majhail NS, Flowers ME, Ness KK, Jagasia M, Carpenter PA, Arora M, et al. (2009) High prevalence of metabolic syndrome after allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 43(1):49–54

    Article  CAS  PubMed  Google Scholar 

  7. Rizzo JD, Wingard JR, Tichelli A, Lee SJ, Van Lint MT, Burns LJ, et al. (2006) Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation: joint recommendations of the European Group for Blood and Marrow Transplantation, Center for International Blood and Marrow Transplant Research, and the American Society for Blood and Marrow Transplantation (EBMT/CIBMTR/ASBMT. Bone Marrow Transplant 37(3):249–261

    Article  CAS  PubMed  Google Scholar 

  8. Lipkin AC, Lenssen P, Dickson BJ (2005) Nutrition issues in hematopoietic stem cell transplantation: state of the art. Nutr Clin Pract 20(4):423–439

    Article  PubMed  Google Scholar 

  9. Mattsson J, Westin S, Edlund S, Remberger M (2006) Poor oral nutrition after allogeneic stem cell transplantation correlates significantly with severe graft-versus-host disease. Bone Marrow Transplant 38(9):629–633

    Article  CAS  PubMed  Google Scholar 

  10. Martin-Salces M, de Paz R, Canales MA, Mesejo A, Hernandez-Navarro F (2008) Nutritional recommendations in hematopoietic stem cell transplantation. Nutrition 24(7–8):769–775

    Article  CAS  PubMed  Google Scholar 

  11. Horsley P, Bauer J, Gallagher B (2005) Poor nutritional status prior to peripheral blood stem cell transplantation is associated with increased length of hospital stay. Bone Marrow Transplant 35(11):1113–1116

    Article  CAS  PubMed  Google Scholar 

  12. Thompson JL, Duffy J (2008) Nutrition support challenges in hematopoietic stem cell transplant patients. Nutr Clin Pract 23(5):533–546

    Article  PubMed  Google Scholar 

  13. Bozzetti F, Arends J, Lundholm K, Micklewright A, Zurcher G, Muscaritoli M, et al. (2009) ESPEN guidelines on parenteral nutrition: non-surgical oncology. Clin Nutr 28(4):445–454

    Article  CAS  PubMed  Google Scholar 

  14. Tichelli A, Passweg J, Wojcik D, Rovo A, Harousseau JL, Masszi T, et al. (2008) Late cardiovascular events after allogeneic hematopoietic stem cell transplantation: a retrospective multicenter study of the Late Effects Working Party of the European Group for Blood and Marrow Transplantation. Haematologica 93(8):1203–1210

    Article  PubMed  Google Scholar 

  15. Urbain PBJ, Lambert C, Finke J, Bertz H, Biesalski HK (2013) Longitudinal follow up of nutritional status amd its influencing factor in adults undergoing allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 48:446–451

    Article  CAS  PubMed  Google Scholar 

  16. McQuellon RP, Russell GB, Cella DF, Craven BL, Brady M, Bonomi A, et al. (1997) Quality of life measurement in bone marrow transplantation: development of the functional assessment of cancer therapy-bone marrow transplant (FACT-BMT) scale. Bone Marrow Transplant 19(4):357–368

    Article  CAS  PubMed  Google Scholar 

  17. Pavletic SZ, Martin P, Lee SJ, Mitchell S, Jacobsohn D, Cowen EW, et al. (2006) Measuring therapeutic response in chronic graft-versus-host disease: National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: IV. Response criteria working group report. Biol Blood Marrow Transplant. 12(3):252–266

    Article  PubMed  Google Scholar 

  18. Lee S, Cook EF, Soiffer R, Antin JH (2002) Development and validation of a scale to measure symptoms of chronic graft-versus-host disease. Biol Blood Marrow Transplant 8(8):444–452

    Article  PubMed  Google Scholar 

  19. Lovibond SH LP. Manual for the depression anxiety stress scales: Psychology Foundation of Australia; 1996.

  20. Tedeschi RG, Calhoun LG (1996) The posttraumatic growth inventory: measuring the positive legacy of trauma. J Trauma Stress 9(3):455–471

    Article  CAS  PubMed  Google Scholar 

  21. Greenberg DB, Kornblith AB, Herndon JE, Zuckerman E, Schiffer CA, Weiss RB, et al. (1997) Quality of life for adult leukemia survivors treated on clinical trials of cancer and leukemia group B during the period 1971-1988: predictors for later psychologic distress. Cancer 80(10):1936–1944

    Article  CAS  PubMed  Google Scholar 

  22. Kornblith AB, Huang HQ, Walker JL, Spirtos NM, Rotmensch J, Cella D (2009) Quality of life of patients with endometrial cancer undergoing laparoscopic international federation of gynecology and obstetrics staging compared with laparotomy: a gynecologic oncology group study.[erratum appears in J Clin Oncol. 2010 Jun 1;28(16):2805]. J Clin Oncol 27(32):5337–5342

    Article  PubMed  PubMed Central  Google Scholar 

  23. Webster K, Cella D, Yost K (2003) The functional assessment of chronic illness therapy (FACIT) measurement system: properties, applications, and interpretation. Health Qual Life Outcomes 1:79

    Article  PubMed  PubMed Central  Google Scholar 

  24. WHO. Body Mass Index – BMI WHO Regional Office for Europe UN City Marmorvej 51 DK-2100 Copenhagen Denmark: World Health Organization; 2015. Available from: http://www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi.

  25. Lenssen PS (1990) ME; Cheney, CL; Nims, JW; Sullivan, KM; stern, JM; Moe, G; Aker, SN. Prevalence of nutrition-related problems among long-term survivors of allogeneic marrow transplantation. J Am Diet Assoc 90(6):835–842

    CAS  PubMed  Google Scholar 

  26. Government A. Australian Bureau of Statistics Australian Health Survey 2011–2012. Available from: http://www.aihw.gov.au/overweight-and-obesity/.

  27. Raynard B, Nitenberg G, Gory-Delabaere G, Bourhis JH, Bachmann P, Bensadoun RJ, et al. (2003) Summary of the standards, options and recommendations for nutritional support in patients undergoing bone marrow transplantation (2002. Br J Cancer 89(Suppl 1):S101–S106

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

This research was funded by the New South Wales Agency of Clinical Innovation Blood and Marrow Transplant Network and supported by the Northern Blood Research Centre.

Author information

Authors and Affiliations

  1. Nutrition Services, Royal North Shore Hospital, Building 30, Level 2, Pacific Highway, St Leonards, NSW, 2065, Australia

    Jennifer Smith & Christine Poon

  2. Blood and Marrow Transplant Network, New South Wales Agency for Clinical Innovation, Sydney, NSW, Australia

    Nicole Gilroy & Gemma Dyer

  3. Westmead Breast Cancer Institute, Sydney, NSW, Australia

    Masura Kabir

  4. Department of Haematology, Royal North Shore Hospital, Sydney, NSW, Australia

    Lisa Brice, Matthew Greenwood, Christopher Ward & Ian Kerridge

  5. Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia

    Gemma Dyer, Matthew Greenwood, Christopher Ward & Ian Kerridge

  6. Department of Haematology, Westmead Hospital, Sydney, NSW, Australia

    Megan Hogg, Gillian Huang & John Kwan

  7. Northern Blood Research Centre, Kolling Institute, University of Sydney, Sydney, NSW, Australia

    Matthew Greenwood, Christopher Ward & Ian Kerridge

  8. Department of Haematology, St Vincent’s Hospital, Sydney, NSW, Australia

    John Moore & Jeff Tan

  9. Department of Haematology, Prince of Wales Hospital, Sydney, NSW, Australia

    Mark Hertzberg

  10. Department of Haematology, Calvary Mater Newcastle, Sydney, NSW, Australia

    Louisa Brown

  11. Institute of Haematology, Royal Prince Alfred Hospital, Sydney, NSW, Australia

    Stephen Larsen

Authors
  1. Jennifer Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christine Poon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nicole Gilroy
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Masura Kabir
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lisa Brice
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gemma Dyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Megan Hogg
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Matthew Greenwood
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. John Moore
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Mark Hertzberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Louisa Brown
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Jeff Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Gillian Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. John Kwan
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Stephen Larsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Christopher Ward
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Ian Kerridge
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jennifer Smith.

Ethics declarations

Conflict of interest

The authors have no conflict of interest.

Additional information

Jennifer Smith and Christine Poon contributed equally to this work

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Smith, J., Poon, C., Gilroy, N. et al. Nutritional issues and body weight in long-term survivors of allogeneic blood and marrow transplant (BMT) in NSW Australia. Support Care Cancer 25, 137–144 (2017). https://doi.org/10.1007/s00520-016-3398-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-016-3398-5

Keywords

Search

Navigation