Eduardo Fernanda de Paula, Bezinelli Leticia Mello, Gobbi Marcella Ferreira, Pereira Andrea Z, Vogel Cristina, Hamerschlak Nelson, Corrêa Luciana
a Bone Marrow Transplantation Unit, Hospital Israelita Albert Einstein , São Paulo , Brazil.
b Pathology Department , School of Dentistry, University of São Paulo , São Paulo , Brazil.
Nutr Cancer. 2018 Feb-Mar;70(2):241-248. doi: 10.1080/01635581.2018.1412476. Epub 2017 Dec 26.
The aim of this study was to evaluate whether digestive tract mucositis is a predictive factor for body weight (BW) alterations during hematopoietic stem cell transplantation (HSCT). Data about characteristics of transplantation, initial nutritional conditions and gastrointestinal mucositis were collected from adult patients (n = 105) who underwent autologous and allogeneic HSCT. Oral mucositis (OM) was not a predictive factor for BW loss, but it was an independent factor for BW gain in autologous HSCT (β = 0.329, P = 0.021). Busulfan-fludarabine conditioning regimen (β = 1.531, P = 0.011) and gender (β = 1.109, P = 0.038) were significant independent risk factors for BW loss in allogeneic HSCT. Overall survival (OS) was significantly affected by the duration of OM in autologous HSCT (HR = 1.243, P = 0.008). In allogeneic HSCT, BW loss (HR = 1.308, P = 0.049) and diarrhea (HR = 1.139, P = 0.012) interfered significantly with OS. In conclusion, OM was not a risk factor for BW loss, but it influenced BW gain and had a negative impact on OS in autologous HSCT patients. Intestinal mucositis explained partially the BW loss and had a negative impact on OS in allogeneic HSCT.
本研究的目的是评估在造血干细胞移植(HSCT)期间,消化道黏膜炎是否是体重(BW)改变的一个预测因素。收集了接受自体和异基因HSCT的成年患者(n = 105)的移植特征、初始营养状况和胃肠道黏膜炎的数据。口腔黏膜炎(OM)不是体重减轻的预测因素,但在自体HSCT中是体重增加的独立因素(β = 0.329,P = 0.021)。白消安-氟达拉滨预处理方案(β = 1.531,P = 0.011)和性别(β = 1.109,P = 0.038)是异基因HSCT中体重减轻的显著独立危险因素。在自体HSCT中,总体生存(OS)受OM持续时间的显著影响(HR = 1.243,P = 0.008)。在异基因HSCT中,体重减轻(HR = 1.308,P = 0.049)和腹泻(HR = 1.139,P = 0.012)对OS有显著干扰。总之,OM不是体重减轻的危险因素,但在自体HSCT患者中影响体重增加并对OS有负面影响。肠道黏膜炎部分解释了异基因HSCT中的体重减轻,并对OS有负面影响。