The impact of pretransplant malnutrition on allogeneic hematopoietic stem cell transplantation outcomes.

Autor:	Hirose EY; Hospital Sírio Libanês, São Paulo, Brazil; Disciplina de Hematologia e Hemoterapia, Universidade Federal de São Paulo, São Paulo, Brazil., de Molla VC; Hospital Sírio Libanês, São Paulo, Brazil; Disciplina de Hematologia e Hemoterapia, Universidade Federal de São Paulo, São Paulo, Brazil. Electronic address: vinciuscamposdemolla@gmail.com., Gonçalves MV; Disciplina de Hematologia e Hemoterapia, Universidade Federal de São Paulo, São Paulo, Brazil., Pereira AD; Hospital Sírio Libanês, São Paulo, Brazil; Disciplina de Hematologia e Hemoterapia, Universidade Federal de São Paulo, São Paulo, Brazil., Szor RS; Hospital Sírio Libanês, São Paulo, Brazil., da Fonseca ARBM; Hospital Sírio Libanês, São Paulo, Brazil; Disciplina de Hematologia e Hemoterapia, Universidade Federal de São Paulo, São Paulo, Brazil., Fatobene G; Hospital Sírio Libanês, São Paulo, Brazil., Serpa MG; Hospital Sírio Libanês, São Paulo, Brazil., Xavier EM; Hospital Sírio Libanês, São Paulo, Brazil., Tucunduva L; Hospital Sírio Libanês, São Paulo, Brazil., Rocha V; Hospital Sírio Libanês, São Paulo, Brazil; Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo/ICESP, São Paulo, Brazil; Churchill Hospital, NHS-BT, Oxford, United Kingdom., Novis Y; Hospital Sírio Libanês, São Paulo, Brazil., Arrais-Rodrigues C; Hospital Sírio Libanês, São Paulo, Brazil; Disciplina de Hematologia e Hemoterapia, Universidade Federal de São Paulo, São Paulo, Brazil.
Jazyk:	angličtina
Zdroj:	Clinical nutrition ESPEN [Clin Nutr ESPEN] 2019 Oct; Vol. 33, pp. 213-219. Date of Electronic Publication: 2019 Jun 11.
DOI:	10.1016/j.clnesp.2019.05.005
Abstrakt:	Background: Malnutrition is a common finding in allogeneic hematopoietic stem cell transplantation (alloHSCT) patients, and there is some evidence that malnutrition might negatively affect the transplant outcomes. Method: We performed a retrospective study with 148 patients aged 18-75 years, who underwent alloHSCT between 2011 and 2017. Patients were classified according to the body mass index (BMI) and the Subjective Global Assessment (SGA). The SGA was assessed on the day of hospitalization for the transplant, and classifies patients into three groups: A (well-nourished), B (moderately malnourished) and C (severely malnourished). Results: The SGA classified 49 (33%) patients as well-nourished, 54 (37%) as moderately malnourished, and 45 (30%) as severely malnourished. SGA-C was also associated with severe acute graft versus host disease (aGVHD) with a cumulative incidence (CI) of 31% vs. a CI of 14% for combined well-nourished or moderately malnourished group (SGA-A or -B, P = 0.017). In multivariate analysis, SGA-C compared to SGA-A or -B, remained as an independent risk factor for aGVHD (hazard ratio - HR 1.68, 95% confidence interval - 95% CI 1.02-2.74), and nonrelapse mortality (NRM - HR 3.63, 95% CI 1.76-7.46), worse progression free survival (HR 2.12, 95% CI 1.25-3.60), and worse overall survival (HR 3.27, 95% CI 1.90-5.64). Conclusion: Malnutrition increases the risk of aGVHD and NRM and has a negative impact on survival. (Copyright © 2019 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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