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Nutritional status independently affects quality of life of patients with systemic immunoglobulin light-chain (AL) amyloidosis

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Abstract

Nutritional status is an independent prognostic factor in immunoglobulin light-chain amyloidosis (AL), but its influence on quality of life (QoL) is unknown. The aim of this cross-sectional study was to investigate the association between nutritional status and QoL in AL patients at diagnosis. One hundred and fifty consecutive patients with biopsy-proven AL were assessed for nutritional status by anthropometry [body mass index, unintentional weight loss (WL) in the previous 6 months and mid-arm muscle circumference (MAMC)], biochemistry (serum prealbumin), and semiquantitative food intake at referral. QoL was assessed by the Medical Outcomes Study 36-item Short Form General Health Survey. The composite physical component summary (PCS) and the mental component summary (MCS) for AL outpatients were 36.2 ± 10.1 and 44.9 ± 11.3, respectively (p < 0.001 for both vs the population norms of 50). In multivariate linear regression models adjusted for gender, age, Eastern Cooperative Oncology Group performance status, the number of organs involved, the severity of cardiac damage, C-reactive protein, energy intake, and WL, PCS was significantly lower for serum prealbumin <200 mg/L and MAMC <10th percentile (adjusted difference 3.8, 95% CI 0.18–7.5, p = 0.040 and 5.3, 95% CI 2.0–8.7, p = 0.002, respectively). MCS was decreased by 0.47 (95% CI 0.18–0.75, p = 0.002) for each kilogram of body weight lost in the previous 6 months. Nutritional status independently affects QoL in AL patients since diagnosis. Nutritional evaluation should be integral part of the clinical assessment of AL patients. Nutritional support intervention trials are warranted in such patients' population.

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Conflict of interest

All authors approved the final version of the manuscript and indicated no potential conflicts of interest.

Funding

This study was supported by grants from the Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

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Authors and Affiliations

  1. Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100, Pavia, Italy

    Riccardo Caccialanza, Emanuele Cereda, Chiara Bonardi, Barbara Cameletti & Elisabetta Montagna

  2. Amyloidosis Research and Treatment Center, Biotechnology Research Laboratories, Department of Biochemistry, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy

    Giovanni Palladini, Catherine Klersy, Paola Russo, Andrea Foli, Paolo Milani, Francesca Lavatelli & Giampaolo Merlini

  3. Biometry and Clinical Epidemiology Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    Catherine Klersy

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  1. Riccardo Caccialanza
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  2. Giovanni Palladini
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  3. Catherine Klersy
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Correspondence to Riccardo Caccialanza.

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Caccialanza, R., Palladini, G., Klersy, C. et al. Nutritional status independently affects quality of life of patients with systemic immunoglobulin light-chain (AL) amyloidosis. Ann Hematol 91, 399–406 (2012). https://doi.org/10.1007/s00277-011-1309-x

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  • DOI: https://doi.org/10.1007/s00277-011-1309-x

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