Toro Juan J, Haile David J, Chao Ju-Hsien, Schneider Deanna, Jewell Pamela S, Lee Shuko, Freytes César O
South Texas Veterans Health Care System, Audie L. Murphy Memorial Veterans Hospital, San Antonio, Texas, USA.
Biol Blood Marrow Transplant. 2009 Sep;15(9):1060-5. doi: 10.1016/j.bbmt.2009.05.004. Epub 2009 Jun 26.
The nutritional assessment of patients prior to autologous peripheral blood stem cell transplantation (APBSCT) is labor intensive. A simple method of nutritional assessment prior to APSCT would be extremely helpful, especially if this method could identify patients at high risk of transplant-related complications. The Department of Veterans Affairs (VA) developed a Nutritional Status Classification Scheme (NSCS) to identify nutritionally compromised inpatients rapidly and reliably. The objective of this study was to determine if the use of the VA-NSCS could be utilized as a tool for the evaluation of patients prior to APBSCT and to determine if this tool could be used to identify patients at high risk of transplant-related complications. The nutritional status of 128 patients who underwent APBSCT was assessed by a registered dietician, utilizing the VA-NSCS, upon admission to the hospital and prior to conditioning regimen. Patients with moderately compromised nutritional status pretransplantation experienced a higher incidence of infections, longer duration of diarrhea, and longer length of hospital stay when compared to patients with normal or mildly compromised nutritional status. Our study demonstrates that the VA-NSCS, a simple and inexpensive tool to assess nutritional status, was useful in determining the pretransplant nutritional status of patients with lymphogenous malignancies who underwent APBSCT. In addition, this method was able to identify patients at a higher risk of posttransplant complications. Future studies should be undertaken to determine the optimal method for the nutritional assessment of autologous stem cell transplant candidates.
在进行自体外周血干细胞移植(APBSCT)之前对患者进行营养评估需要耗费大量人力。一种简单的APBSCT前营养评估方法将非常有帮助,特别是如果这种方法能够识别出有移植相关并发症高风险的患者。退伍军人事务部(VA)制定了一种营养状况分类方案(NSCS),以快速、可靠地识别营养状况不佳的住院患者。本研究的目的是确定VA-NSCS是否可作为APBSCT前评估患者的工具,并确定该工具是否可用于识别有移植相关并发症高风险的患者。128例接受APBSCT的患者在入院时和预处理方案前,由注册营养师使用VA-NSCS对其营养状况进行评估。与营养状况正常或轻度受损的患者相比,移植前营养状况中度受损的患者感染发生率更高、腹泻持续时间更长、住院时间更长。我们的研究表明,VA-NSCS作为一种简单且廉价的营养状况评估工具,对于确定接受APBSCT的淋巴源性恶性肿瘤患者的移植前营养状况很有用。此外,这种方法能够识别出移植后并发症风险较高的患者。未来应开展研究以确定自体干细胞移植候选者营养评估的最佳方法。