Nutrition and Dietetics, Central Michigan University, Mt. Pleasant, Michigan, USA.
Nutr Cancer. 2022;74(8):2731-2747. doi: 10.1080/01635581.2021.2020303. Epub 2021 Dec 28.
According to World Health Organization, over 50,000 hematopoietic stem cell transplants (HSCTs) are performed annually worldwide. Though HSCT can extend life-expectancy and improve disease-related health burdens, it is not without risks. Post-transplant overall survival is improving; therefore, it is imperative that factors contributing to or impeding further improvements are well understood. The purpose of this systematic review is to explore current data on body composition (specifically weight loss, BMI, obesity and sarcopenia) and the relation to HSCT outcomes. A literature search was conducted via PubMed and Web of Science databases. Key words included "body composition," "sarcopenia," "hematopoietic stem cell transplant," "malnutrition," "body mass index," and "obesity." Results indicated that 16 out of 18 analyzed studies found a statistically significant relationship between body composition, in particular higher BMI and weight loss, and at least one survival-related outcome variable (eg., non-relapse mortality, overall survival and/or relapse). Based on the findings of this review, body composition, whether evaluated before or during HSCT, can impact a wide variety of post-transplant outcomes. This speaks to the importance of evaluating patients pre-transplant, identifying potential risk factors for worsened outcomes, and providing immediate interventions in order to optimize transplant outcomes.
据世界卫生组织统计，全球每年有超过 5 万例造血干细胞移植（HSCT）。尽管 HSCT 可以延长预期寿命并改善与疾病相关的健康负担，但它并非没有风险。移植后总生存率在提高；因此，必须充分了解影响进一步改善的因素。本系统评价的目的是探讨目前关于身体成分（特别是体重减轻、BMI、肥胖和肌肉减少症）与 HSCT 结果的关系。通过 PubMed 和 Web of Science 数据库进行了文献检索。关键词包括“身体成分”、“肌肉减少症”、“造血干细胞移植”、“营养不良”、“BMI”和“肥胖”。结果表明，在分析的 18 项研究中，有 16 项研究发现身体成分（特别是较高的 BMI 和体重减轻）与至少一种与生存相关的结果变量（如非复发死亡率、总生存率和/或复发）之间存在统计学显著关系。基于本综述的研究结果，身体成分，无论是在 HSCT 之前还是期间进行评估，都可能影响移植后的多种结果。这表明评估患者在移植前，确定预后不良的潜在风险因素，并立即进行干预，以优化移植结果的重要性。
