Espinoza Marcela, Perelli Javiera, Olmos Roberto, Bertin Pablo, Jara Verónica, Ramírez Pablo
School of Medicine, Pontificia Universidad Católica de Chile (UC), Santiago, Chile.
School of Medicine, Pontificia Universidad Católica de Chile (UC), Santiago, Chile.
Rev Bras Hematol Hemoter. 2016 Jan-Feb;38(1):7-14. doi: 10.1016/j.bjhh.2015.10.002. Epub 2015 Nov 27.
Nutritional support is pivotal in patients submitted to hematopoietic stem cell transplantation. Nutritional status has been associated with time of engraftment and infection rates. In order to evaluate the association between nutritional parameters and clinical outcomes after transplantation a cohort of transplant patients was retrospectively evaluated.
All 50 patients transplanted between 2011 and 2014 were included. The nutritional status before transplantation, ten days after transplantation and before discharge was assessed including anthropometry, body mass index, albumin, prealbumin and total urinary nitrogen.
The median follow-up time was 41 months and the median age of patients was 41 years. Thirty-two underwent allogeneic and 18 autologous transplants. Diagnoses included acute leukemias (n=27), lymphoma (n=7), multiple myeloma (n=13), and aplastic anemia (n=3). Thirty-seven patients developed mucositis (three Grade 1, 15 Grade 2, 18 Grade 3 and one Grade 4), and twenty-two allogeneic, and five autologous transplant patients required total parenteral nutrition. Albumin and total urinary nitrogen were associated with length of hospital stay and platelet and neutrophil engraftment. None of the nutritional parameters evaluated were associated with overall survival. Non-relapse mortality was 14% and overall survival was 79% at 41 months of follow-up.
After hematopoietic stem cell transplantation, high catabolism was associated with longer length of hospital stay, the need of total parenteral nutrition and platelet and neutrophil engraftment times. Nutritional parameters were not associated with overall survival.
营养支持在接受造血干细胞移植的患者中至关重要。营养状况与植入时间和感染率相关。为了评估营养参数与移植后临床结局之间的关联，对一组移植患者进行了回顾性评估。
纳入了2011年至2014年间接受移植的所有50例患者。评估了移植前、移植后十天和出院前的营养状况，包括人体测量学、体重指数、白蛋白、前白蛋白和总尿氮。
中位随访时间为41个月，患者中位年龄为41岁。32例接受了异基因移植，18例接受了自体移植。诊断包括急性白血病（n = 27）、淋巴瘤（n = 7）、多发性骨髓瘤（n = 13）和再生障碍性贫血（n = 3）。37例患者发生了粘膜炎（3例1级、15例2级、18例3级和1例4级），22例异基因移植患者和5例自体移植患者需要全胃肠外营养。白蛋白和总尿氮与住院时间、血小板和中性粒细胞植入相关。评估的营养参数均与总生存期无关。随访41个月时，非复发死亡率为14%，总生存率为79%。
造血干细胞移植后，高分解代谢与住院时间延长、全胃肠外营养需求以及血小板和中性粒细胞植入时间相关。营养参数与总生存期无关。
