Smith Jennifer, Poon Christine, Gilroy Nicole, Kabir Masura, Brice Lisa, Dyer Gemma, Hogg Megan, Greenwood Matthew, Moore John, Hertzberg Mark, Brown Louisa, Tan Jeff, Huang Gillian, Kwan John, Larsen Stephen, Ward Christopher, Kerridge Ian
Nutrition Services, Royal North Shore Hospital, Building 30, Level 2, Pacific Highway, St Leonards, NSW, 2065, Australia.
Blood and Marrow Transplant Network, New South Wales Agency for Clinical Innovation, Sydney, NSW, Australia.
Support Care Cancer. 2017 Jan;25(1):137-144. doi: 10.1007/s00520-016-3398-5. Epub 2016 Sep 2.
The aims of this study were to describe the long-term nutrition, body weight and body image issues facing survivors of Allogeneic Blood and Marrow Transplant (BMT) and their impact on quality of life. It also describes survivors' perception of enteral feeding during BMT.
Four hundred and forty-one survivors who had undergone a BMT in NSW, Australia between 2000 and 2012 (n = 441/583) completed the Sydney Post BMT Study Survey (SPBS).
Forty-five percent of survivors less than 2-year post-transplant reported a dry mouth, 36 % reported mouth ulcers and 19 % had diarrhoea. This was consistent across all survivor groups, regardless of time since transplant. Patients with one or more gastrointestinal (GI) symptoms had significantly lower quality of life scores. There was a significant difference in quality of life scores when comparing those with no GI symptoms to those with one or more symptoms (P = <0.0001). Quality of life was significantly higher in those who once again enjoyed mealtimes (P < 0.0001). Males were more likely to be satisfied with their body weight compared to females (P = 0.009). The median body mass index (BMI) for all patients reporting body weight satisfaction was significantly lower (BMI 23.5) than those reporting dissatisfaction (BMI 27.5) (P = <0.0001). Survivors who had a normal BMI had significantly higher rates of body weight satisfaction compared to underweight, overweight and obese survivors (P = <0.0001). Those survivors who were overweight or obese were significantly more likely to be diabetic (P = 0.008).
This study revealed an important relationship between gastrointestinal symptoms, body weight and body image and survivor's quality of life. It provides further support for the importance of nutrition therapy post-BMT.
本研究旨在描述异基因造血干细胞移植（BMT）幸存者面临的长期营养、体重和身体形象问题及其对生活质量的影响。同时也描述了幸存者在BMT期间对肠内喂养的认知。
2000年至2012年间在澳大利亚新南威尔士州接受BMT的441名幸存者（n = 441/583）完成了悉尼BMT后研究调查（SPBS）。
移植后不到2年的幸存者中，45%报告有口干，36%报告有口腔溃疡，19%有腹泻。所有幸存者群体均如此，与移植后的时间无关。有一个或多个胃肠道（GI）症状的患者生活质量得分显著较低。比较无GI症状者与有一个或多个症状者的生活质量得分有显著差异（P = <0.0001）。再次享受用餐时光的人的生活质量显著更高（P < 0.0001）。与女性相比，男性对自己体重更满意（P = 0.009）。所有报告对体重满意的患者的中位体重指数（BMI）（BMI 23.5）显著低于报告不满意的患者（BMI 27.5）（P = <0.0001）。与体重过轻、超重和肥胖的幸存者相比，BMI正常的幸存者对体重满意的比例显著更高（P = <0.0001）。那些超重或肥胖的幸存者患糖尿病的可能性显著更高（P = 0.008）。
本研究揭示了胃肠道症状、体重和身体形象与幸存者生活质量之间的重要关系。它为BMT后营养治疗的重要性提供了进一步支持。
