Nutrition and Acute Myeloid Leukemia and Myelodysplastic Syndromes in Older Adults (Aged ≥60): A Scoping Review

Abstract

Background: Acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) commonly affect older adults (aged ≥60). Treatments are often intensive, with side effects influencing patients' eating abilities and, consequently, nutritional status, which can influence treatment outcomes.

Objective: For older adults with AML and/or MDS, what research has been conducted to describe their nutrition experiences? And, what research has been conducted regarding the effects of nutrition experiences on physical health, psychosocial health, and quality of life?

Methods: A scoping review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines to search on April 30, 2024, in PubMed, Cumulative Index to Nursing and Allied Health Literature, and Scopus. Criteria included English language, peer-reviewed, empirical studies with unique findings regarding nutrition for older adults (aged ≥60) with AML and/or MDS. Studies focusing on the risk of future cancers and drug trials were excluded.

Results: Forty-two studies published from 1992 to 2024 met the inclusion criteria. Twenty-four articles focused on patients with AML, 16 on patients with MDS, and 2 reported both. Most quantitative studies were retrospective (n = 20), and only 5 assessed nutrition over time. Nutrition experiences included malnutrition, weight loss, sarcopenia, impaired renal function, diabetes, vitamin deficiencies, mucositis, dysphagia, decreased appetite or intake, altered taste, and gastrointestinal symptoms (eg, nausea and diarrhea). Studies described the effects on health and quality of life, including significant relationships with functional status, clinical complications, comorbidities, and mortality.

Conclusions: Patients with AML or MDS may face varied experiences with nutrition, especially related to malnutrition. Challenges may be associated with declines in physical health and quality of life. Importantly, no studies in this review reported effects on psychosocial outcomes, and few reported race/ethnicity, which are recommended to be measured in future studies to understand potential challenges and outcomes. The findings of this review may inform further research on nutritional health and intervention development, and effects on quality of life.

Keywords: Acute myeloid leukemia; Eating; Myelodysplastic syndromes; Nutrition; Quality of life.