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. 2023 Jan 9:9:974389.
doi: 10.3389/fnut.2022.974389. eCollection 2022.

Weight loss in children undergoing allogeneic hematopoietic stem cell transplantation within the first 100 days: Its influencing factors and impact on clinical outcomes

Mei Yan  1 , Jian Pan  1 , Jie Huang  2 , Changwei Liu  1 , Xiaona Xia  1 , Ting Zhu  1 , Yuanyuan Wan  1 , Yongjun Fang  2 , Weibing Tang  1
Affiliations

Weight loss in children undergoing allogeneic hematopoietic stem cell transplantation within the first 100 days: Its influencing factors and impact on clinical outcomes

Mei Yan et al. Front Nutr. .

Abstract

Purpose/objective: This study aimed to evaluate the nutritional status of children subjected to allogeneic hematopoietic stem cell transplantation (alloHSCT) in the first 100 days. Objectives were to clarify the effect of weight loss on clinical outcomes, and to analyze factors influencing weight loss.

Methods: Eighty pediatric patients receiving alloHSCT were enrolled in the study. Body mass index (BMI) z-scores and weight for age (WFA) z-scores were collected. A multivariate regression model was set up to investigate factors affecting weight loss. Post-transplant clinical outcomes relative to weight loss on 100 days after transplantation were analyzed.

Results: At admission, eight patients (10%) were underweight, the number had increased to 23 (30.67%) by 100 days post-HSCT. On day + 100, only nutrition screening tool for childhood cancer (SCAN) scores ≥ 3 (OR: 4.474, 95% CI: 1.215, 16.472; P = 0.024) and acute graft versus host disease (aGVHD) (OR: 9.915, 95% CI: 3.302, 29.771; P < 0.001) were regarded as significant influencing factors of weight loss. The Weight loss ≥ 5% group was associated with longer hospital stays (P = 0.001), greater cost of inpatient treatment (P = 0.001), and a higher incidence of 100-day re-admission and intensive care unit (ICU) transfer (P = 0.03 and P = 0.033, respectively). Cumulative number of fever days (P = 0.023) and antibiotic use (P = 0.007) also increased significantly. The Weight loss ≥ 5% group had a significantly lower one-year overall survival rate compared with the Weight loss < 5% group (P = 0.015).

Conclusion: Pediatric patients' nutritional status declined significantly after HSCT. Weight loss within the first 100 days influenced short-term clinical outcomes and one-year overall survival.

Keywords: allo and autologous transplantation; graft versus host disease; pediatric; screening tools; weight (mass).

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Changes of mean body mass index (BMI) z-scores and weight for age (WFA) z-scores during treatment of alloHSCT (at initial admission and the day of transplantation, day + 7, day + 14, day + 21, day + 30, and day + 100 after HSCT).
FIGURE 2
FIGURE 2
Kaplan Meier curves of survival for weight loss < 5% group (continuous line) and weight loss ≥ 5% (dashed line).
FIGURE 3
FIGURE 3
Kaplan Meier curves of treatment-related mortality (TRM) for weight loss < 5% group (continuous line) and weight loss ≥ 5% (dashed line).
See this image and copyright information in PMC

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