在接受大剂量化疗和自体干细胞支持治疗期间，多发性骨髓瘤患者的营养状况降低。

Reduced nutritional status among multiple myeloma patients during treatment with high-dose chemotherapy and autologous stem cell support.

机构信息

Department of Hematology, Oslo University Hospital, Ullevaal, Oslo, Norway.

出版信息

Clin Nutr. 2010 Aug;29(4):488-91. doi: 10.1016/j.clnu.2009.12.002. Epub 2009 Dec 30.

DOI:10.1016/j.clnu.2009.12.002

PMID:20044183

Abstract

BACKGROUND & AIMS: Multiple myeloma (MM) ranks among the most frequent blood cancers in adults. Optimal treatment consists of high-dose chemotherapy and autologous stem cell transplantation. Health-related quality of life (HRQoL) is reduced before, during, and after therapy. Several HRQoL items are associated with nutritional health, e.g., nausea/vomiting, appetite loss and fatigue. It is unknown whether nutritional status in MM is affected by treatment. Hence we assessed nutritional status before, during and (1/2) year after treatment-start.

METHODS

We applied anthropometry (height, weight, hand-grip strength, triceps skinfold) and plasma concentrations of biomarkers to assess nutritional status. HRQoL was determined with the EORTC QLQ-C30 questionnaire.

RESULTS

The anthropometrical parameters all decreased (p<0.05) during treatment, but were restored at the end of the observation period. Albumin and the fat-soluble vitamins D and E followed a similar pattern, whereas transferrin and vitamin A were unchanged (p>0.05). Interestingly, markers of thyroid function declined and remained low (p<0.05) even 6 months after start of therapy. Nutrition-associated symptoms used as markers of HRQoL worsened during therapy, but returned to pre-therapy levels.

CONCLUSION

Intensive therapy in MM is associated with a decline in both nutritional status and health-related quality of life.

摘要

背景与目的

多发性骨髓瘤（MM）是成人中最常见的血液癌之一。最佳治疗方法包括大剂量化疗和自体干细胞移植。治疗前、治疗中和治疗后健康相关生活质量（HRQoL）均会降低。许多 HRQoL 指标与营养健康有关，例如恶心/呕吐、食欲减退和疲劳。目前尚不清楚 MM 患者的营养状况是否受到治疗的影响。因此，我们在治疗开始前、治疗期间和治疗开始后半年评估了患者的营养状况。

方法

我们应用人体测量学（身高、体重、握力、肱三头肌皮褶厚度）和血浆生物标志物浓度来评估营养状况。使用 EORTC QLQ-C30 问卷来确定 HRQoL。

结果

在治疗期间，所有人体测量参数均下降（p<0.05），但在观察期结束时恢复正常。白蛋白和脂溶性维生素 D 和 E 也呈现出类似的模式，而转铁蛋白和维生素 A 则保持不变（p>0.05）。有趣的是，甲状腺功能的标志物下降且保持较低水平（p<0.05），即使在治疗开始后 6 个月也是如此。用作 HRQoL 标志物的与营养相关的症状在治疗期间恶化，但恢复到治疗前水平。