Koç Nevra, Gündüz Mehmet, Tavil Betül, Azik M Fatih, Coşkun Zeynep, Yardımcı Hülya, Uçkan Duygu, Tunç Bahattin
From the Division of Pediatric Nutrition and Metabolism, Ankara Children's Hematology-Oncology Hospital.
Exp Clin Transplant. 2017 Aug;15(4):458-462. doi: 10.6002/ect.2015.0298. Epub 2016 Oct 20.
The aim of this study was to evaluate nutritional status in children who underwent hematopoietic stem cell transplant compared with a healthy control group. A secondary aim was to utilize mid-upper arm circumference as a measure of nutritional status in these groups of children.
Our study group included 40 children (18 girls, 22 boys) with mean age of 9.2 ± 4.6 years (range, 2-17 y) who underwent hematopoietic stem cell transplant. Our control group consisted of 20 healthy children (9 girls, 11 boys). The children were evaluated at admission to the hospital and followed regularly 3, 6, 9, and 12 months after discharge from the hospital.
In the study group, 27 of 40 patients (67.5%) received nutritional support during hematopoietic stem cell transplant, with 15 patients (56%) receiving enteral nutrition, 6 (22%) receiving total parenteral nutrition, and 6 (22%) receiving enteral and total parenteral nutrition. Chronic malnutrition rate in the study group was 47.5% on admission to the hospital, with the control group having a rate of 20%. One year after transplant, the rate decreased to 20% in the study group and 5% in the control group. The mid-upper arm circumference was lower in children in the study group versus the control group at the beginning of the study (P < .05). However, there were no significant differences in mid-upper arm circumference measurements between groups at follow-up examinations (P > .05). During follow-up, all anthropometric measurements increased significantly in both groups.
Monitoring nutritional status and initiating appropriate nutritional support improved the success of hematopoietic stem cell transplant and provided a more comfortable process during the transplant period. Furthermore, mid-upper arm circumference is a more sensitive, useful, and safer parameter that can be used to measure nutritional status of children who undergo hematopoietic stem cell transplant.
本研究旨在评估接受造血干细胞移植的儿童与健康对照组儿童的营养状况。次要目的是将上臂中段周长用作这些儿童群体营养状况的一项衡量指标。
我们的研究组包括40名接受造血干细胞移植的儿童(18名女孩,22名男孩),平均年龄为9.2±4.6岁(范围2 - 17岁)。我们的对照组由20名健康儿童(9名女孩,11名男孩)组成。这些儿童在入院时接受评估,并在出院后3、6、9和12个月进行定期随访。
在研究组中,40名患者中有27名(67.5%)在造血干细胞移植期间接受了营养支持,其中15名患者(56%)接受肠内营养,6名(22%)接受全胃肠外营养,6名(22%)接受肠内和全胃肠外营养。研究组入院时慢性营养不良率为47.5%,对照组为20%。移植后一年,研究组该比率降至20%,对照组降至5%。研究开始时,研究组儿童的上臂中段周长低于对照组(P < 0.05)。然而,随访检查时两组之间上臂中段周长测量值无显著差异(P > 0.05)。在随访期间,两组所有人体测量指标均显著增加。
监测营养状况并启动适当的营养支持提高了造血干细胞移植的成功率,并在移植期间提供了更舒适的过程。此外,上臂中段周长是一个更敏感、有用且安全的参数,可用于测量接受造血干细胞移植儿童的营养状况。