Hematology and Bone Marrow Transplantation Unit, Internal Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Support Care Cancer. 2017 Oct;25(10):3085-3093. doi: 10.1007/s00520-017-3716-6. Epub 2017 Apr 24.
Patients subjected to allogeneic hematopoietic stem cell transplantation (HSCT) are at increased nutritional risk which in turn may alter their outcome. For providing good nutritional care for patients, it is important to analyze risk factors influencing nutritional status during and after HSCT.
Fifty patients undergoing allogeneic HSCT were subjected to nutritional status assessment by using the patient-generated subjective global assessment (PG-SGA) at initial admission, day 30 and day 180.
Two patients (4%) had malnutrition at admission, 36 (72%) at day 30, and 24 (48%) at day 180. At day 30, comorbidity index higher than 0 and fever lasting for more than 1 week had a significant impact on nutritional status (P = .004 and P = .006, respectively). Regarding day 180, comorbidity index higher than 0 and presence of ≥grade II acute gastrointestinal graft versus host disease (GI GVHD) significantly influenced nutritional status (P = .017 and P = .026, respectively). Well-nourished patients at admission and day 180 had a significantly higher overall survival (OS) in comparison to malnourished patients (P < .001 and P = .012, respectively). Nutritional status at admission and day 180 had a significant influence on OS in multivariate analysis (P = .039 and P = .032, respectively).
Allogeneic HSCT patients having high comorbidity index, developing prolonged fever, and experiencing ≥grade II acute GI GVHD suffer from worsening in their nutritional status during hospitalization and after discharge. Also, nutritional status at admission and day 180 significantly influences their survival.
接受异基因造血干细胞移植（HSCT）的患者存在较高的营养风险，这反过来可能会改变他们的预后。为了为患者提供良好的营养护理，分析影响 HSCT 期间和之后营养状况的危险因素非常重要。
50 名接受异基因 HSCT 的患者在初始入院时、第 30 天和第 180 天使用患者生成的主观整体评估（PG-SGA）进行营养状况评估。
2 名患者（4%）在入院时存在营养不良，36 名患者（72%）在第 30 天，24 名患者（48%）在第 180 天存在营养不良。第 30 天时，合并症指数高于 0 和发热持续超过 1 周对营养状况有显著影响（P=0.004 和 P=0.006）。关于第 180 天，合并症指数高于 0 和存在≥2 级急性胃肠道移植物抗宿主病（GI GVHD）显著影响营养状况（P=0.017 和 P=0.026）。入院和第 180 天营养良好的患者的总生存率（OS）明显高于营养不良的患者（P<0.001 和 P=0.012）。在多变量分析中，入院和第 180 天的营养状况对 OS 有显著影响（P=0.039 和 P=0.032）。
患有高合并症指数、发生持续性发热和出现≥2 级急性 GI GVHD 的异基因 HSCT 患者在住院期间和出院后营养状况恶化。此外，入院和第 180 天的营养状况对他们的生存有显著影响。
