Rieger Christina T, Wischumerski Isabel, Rust Christian, Fiegl Michael
Department of Internal Medicine III, Klinikum der Universität München, Munich, Germany.
Department of Internal Medicine I, Krankenhaus der Barmherzigen Brüder, Munich, Germany.
PLoS One. 2015 Dec 18;10(12):e0145445. doi: 10.1371/journal.pone.0145445. eCollection 2015.
Weight loss in cancer patients has been attributed with significant morbidity and mortality. During allogeneic stem cell transplantation (SCT), oral nutrition is often hampered and hence total parenteral nutrition (TPN) is necessary. We therefore investigated the course of weight during stem cell transplantation and the clinical consequences of weight change.
180 consecutive patients who received allogeneic SCT between January 2010 and December 2011 at our center were analyzed for weight loss, laboratory and clinical parameters.
During SCT, a median decrease of 6.6% of body mass index (BMI) was observed for the whole population (from 25.3 at admission to 23.6 at discharge), and a 1.6fold increase of malnutrition despite use of TPN (28.3% to 45.0%). 55.6% of patients experienced a significant weight loss of ≥5% with a median decrease of 9.2% in BMI. Serum levels of albumin, total protein and cholesterol rapidly decreased during conditioning therapy. After a median of 2.4 years, the median BMI was still only 23.4 (not different from discharge). However, we did not observe a meaningful difference in side effects and survival between patients that did or did not lose weight.
Weight loss is commonly observed during allogeneic SCT despite TPN, but the clinical consequences thereof seem limited: we observed no significant impact on patients with a decrease ≥ 5% in BMI on transplant outcome, side effects or survival.
癌症患者体重减轻与显著的发病率和死亡率相关。在异基因干细胞移植（SCT）期间，口服营养常常受到阻碍，因此全胃肠外营养（TPN）是必要的。我们因此研究了干细胞移植期间的体重变化过程以及体重变化的临床后果。
对2010年1月至2011年12月在我们中心接受异基因SCT的180例连续患者进行体重减轻、实验室和临床参数分析。
在SCT期间，整个人群的体重指数（BMI）中位数下降了6.6%（从入院时的25.3降至出院时的23.6），尽管使用了TPN，但营养不良增加了1.6倍（从28.3%增至45.0%）。55.6%的患者体重显著减轻≥5%，BMI中位数下降9.2%。在预处理治疗期间，血清白蛋白、总蛋白和胆固醇水平迅速下降。中位2.4年后，BMI中位数仍仅为23.4（与出院时无差异）。然而，我们没有观察到体重减轻或未减轻的患者在副作用和生存率方面有有意义的差异。
尽管使用了TPN，但在异基因SCT期间体重减轻仍很常见，但其临床后果似乎有限：我们观察到BMI下降≥5%的患者对移植结果、副作用或生存率没有显著影响。
