Nutrition and Dietetics Department, St Vincent's Hospital, Melbourne, VIC, Australia.
Haematology Department, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.
Support Care Cancer. 2022 Nov;30(11):9341-9350. doi: 10.1007/s00520-022-07358-y. Epub 2022 Sep 12.
Malnutrition is associated with worse outcomes post-haematopoietic stem cell transplantation, with nutrition support recommended for people who are malnourished or have prolonged inadequate energy intake. We investigated associations between nutritional status, nutrition support type and clinical outcomes in adults with multiple myeloma post stem cell transplantation.
Medical records (2015-2020) were reviewed to retrieve demographics, anthropometry, dietary data, nutrition support type (enteral/oral versus parenteral), and clinical outcomes (engraftment time, infection, length of stay, weight changes). Relationships were examined using linear regression modelling and Fisher's exact test.
One hundred thirteen participants were included (61% male; median age 62 years). Fifteen participants (13%) received parenteral and 98 (87%) received enteral/oral nutrition support. Parenteral nutrition was associated with shorter platelet engraftment time by 2.7 days (p = 0.036) and a longer hospital stay by 6.1 days (p < 0.001). Nutrition support was not associated with neutrophil engraftment time (p = 0.365). Inadequate energy intake for ≥ 7 days was not associated with any clinical outcomes (p > 0.05).
Participants who received parenteral nutrition reached platelet engraftment sooner but were in hospital longer. Inadequate energy intake for ≥ 7 days did not impact clinical outcomes. Multi-site prospective studies are warranted to confirm results.
造血干细胞移植后营养不良与预后较差相关，建议对营养不良或能量摄入长期不足的患者进行营养支持。我们研究了多发性骨髓瘤患者造血干细胞移植后营养状况、营养支持类型与临床结局之间的关系。
回顾 2015 年至 2020 年的病历，以获取人口统计学、人体测量学、饮食数据、营养支持类型（肠内/口服与肠外）和临床结局（植入时间、感染、住院时间、体重变化）。采用线性回归模型和 Fisher 确切检验分析相关性。
共纳入 113 名患者（61%为男性；中位年龄 62 岁）。15 名患者（13%）接受了肠外营养，98 名患者（87%）接受了肠内/口服营养支持。与肠内/口服营养支持相比，肠外营养使血小板植入时间缩短 2.7 天（p=0.036），住院时间延长 6.1 天（p<0.001）。营养支持与中性粒细胞植入时间无关（p=0.365）。≥7 天能量摄入不足与任何临床结局均无关（p>0.05）。
接受肠外营养的患者血小板植入更快，但住院时间更长。≥7 天能量摄入不足并不影响临床结局。需要多中心前瞻性研究来证实这些结果。
