Evolution of nutritional status in patients with autologous and allogeneic hematopoietic stem cell transplant

Abstract

Purpose: To describe the nutritional status in patients undergoing hematopoietic stem cell transplant (HSCT) in three different defined moments: at admission to the Bone Marrow Transplant Unit (BMTU), at discharge from the BMTU and at follow-up. We hypothesized that nutrition status declines during hospitalization and recovers at follow-up.

Methods: Prospective cohort study. Nutritional status was determined using the patient-generated subjective global assessment (PG-SGA) at three different defined moments: T1, defined as the time of admission to the BMTU; T2, at the time of discharge from the BMTU; and T3, at follow-up appointment 10 days after discharge. PG-SGA score differences were described among T1, T2, and T3. Participants were adults admitted for any type of HSCT to our BMTU from March 2010 to July 2013. One hundred and twenty-three patients were included.

Results: Subjects (94.3 %) were well nourished at T1, but 59.7 % were classified as malnourished at T2. PG-SGA score was 3.39 (±3.47) at T1, 12.3 (±5.6) at T2, and 6.54 (±4.57) at T3 (p < 0.001). During hospitalization, nutritional status deteriorated more in men than women (10.59 vs. 7.93; p = 0.002), in patients with length of hospital stay greater than 21 days (10.64 vs. 8.45, p = 0.034), in patients younger than 60 years (10.7 vs. 6.42; p = 0.0007), and those individuals with allogeneic transplant (12.45 vs. 8.74; p = 0.0152).

Conclusions: Patients undergoing HSCT were well nourished upon admission to the BMTU. Nutritional status significantly declined during hospitalization and improved at follow-up. However, nutritional intervention may still be required.