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口腔和胃肠道黏膜炎对造血干细胞移植期间体重变化的影响。

Impact of Oral and Gastrointestinal Mucositis on Body Weight Alterations during Hematopoietic Stem Cell Transplantation.

作者信息

Eduardo Fernanda de Paula, Bezinelli Leticia Mello, Gobbi Marcella Ferreira, Pereira Andrea Z, Vogel Cristina, Hamerschlak Nelson, Corrêa Luciana

机构信息

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.

出版信息

Nutr Cancer. 2018 Feb-Mar;70(2):241-248. doi: 10.1080/01635581.2018.1412476. Epub 2017 Dec 26.

DOI:10.1080/01635581.2018.1412476
PMID:29278934
Abstract

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.

摘要

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。

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