Department of Hematology, Japanese Red Cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, Japan.
Int J Hematol. 2019 Nov;110(5):599-605. doi: 10.1007/s12185-019-02723-w. Epub 2019 Aug 12.
Malnutrition before allogeneic hematopoietic cell transplantation (allo-HCT) is associated with poor clinical outcomes. Herein, we evaluated the predictive value of controlling nutritional status (CONUT) in patients undergoing allo-HCT for myeloid malignancies. We retrospectively analyzed 200 patients with myeloid malignancies who underwent allo-HCT for the first time. We evaluated CONUT before the initiation of conditioning and compared malnourished patients (poor CONUT, n = 56) with non-malnourished patients (normal CONUT, n = 144). The cumulative incidence of non-relapse mortality within 100 days (early NRM) was significantly higher in the poor CONUT group than in the normal CONUT group [21.4% (95% CI: 11.8-33.0%) vs. 9.7% (95% CI: 5.6-15.2%); P = 0.025]. In multivariate analysis, poor CONUT was an independent and significant risk factor for early NRM [HR: 2.2 (95% CI: 1.0-4.7); P = 0.048]. The overall 1-year survival rate was significantly lower in the poor CONUT group than in the normal CONUT group [53.3% (95% CI: 39.4-65.4%) vs. 71.0% (95% CI: 62.7-77.7%); P = 0.005]. These findings suggest that CONUT before allo-HCT is a useful predictor of poor outcomes in patients with myeloid malignancies.
异基因造血细胞移植（allo-HCT）前营养不良与不良临床结局相关。在此，我们评估了控制营养状况（CONUT）在接受allo-HCT 治疗髓系恶性肿瘤患者中的预测价值。我们回顾性分析了 200 例首次接受 allo-HCT 治疗的髓系恶性肿瘤患者。我们在预处理前评估了 CONUT，并比较了营养不良患者（较差 CONUT，n=56）与非营养不良患者（正常 CONUT，n=144）。较差 CONUT 组 100 天内非复发死亡率（早期 NRM）的累积发生率明显高于正常 CONUT 组[21.4%（95%CI：11.8-33.0%）vs.9.7%（95%CI：5.6-15.2%）；P=0.025]。多变量分析显示，较差 CONUT 是早期 NRM 的独立且显著危险因素[HR：2.2（95%CI：1.0-4.7）；P=0.048]。较差 CONUT 组的总 1 年生存率明显低于正常 CONUT 组[53.3%（95%CI：39.4-65.4%）vs.71.0%（95%CI：62.7-77.7%）；P=0.005]。这些发现表明，allo-HCT 前 CONUT 是预测髓系恶性肿瘤患者不良结局的有用指标。
