Zhang Luyang, Wang Li, Long Jiewen, Yin Yan, Patil Sandip
Department of Haematology and Oncology, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, 518000, People's Republic of China.
Department of Clinical Nutrition, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, 518000, People's Republic of China.
J Multidiscip Healthc. 2024 May 9;17:2203-2214. doi: 10.2147/JMDH.S463796. eCollection 2024.
This retrospective study evaluated nutritional status and body composition changes in paediatric β-thalassemia (β-TM) patients before and after hematopoietic stem cell transplantation (HSCT), using bioelectrical impedance analysis (BIA), and explored their relationship with HSCT outcomes.
A cohort of 40 paediatric β-TM patients undergoing allogeneic HSCT was assessed for their nutritional status, anthropometric parameters, including body mass index (BMI), weight, and height, and body composition parameters pre-and post-HSCT, focusing on BIA measurements, including intracellular water (ICW), extracellular water (ECW), fat mass (FAT), fat-free mass (FFM), Skeletal Muscle Mass (SMM), soft Lean Mass (SLM), percent body fat (PBF), Body Cell Mass (BCM), Phase angle (PA) and muscle balance pre- and post-HSCT. Post-HSCT clinical outcomes, including acute graft-vs-host disease (aGVHD), engraftment time, oral mucositis (OM), sinusoidal obstruction syndrome (SOS), and diarrhoea in relation to nutrition status after HSCT were analysed.
After HSCT, 28.21% experienced diminished nutritional status, with 71.43% of those who were wasting before HSCT showing diminished nutritional status, significantly higher than the normal group (18.75%, P = 0.012). Anthropometric changes included significant weight reduction (87.5%, 22.15 ± 7.46 vs 20.74 ± 6.57, P < 0.001) and BMI decrease (90%, 15.19 ± 1.70 vs 14.05 ± 1.48, P < 0.001). Body composition parameters, which are FFM, SMM, SLM, ICW, ECW, BCM, and PA (18.26 ± 5.71 vs 17.27 ± 5.19, 8.68 ± 3.30 vs 7.93 ± 3.02, 17.11 ± 5.28 vs 16.06 ± 4.84, 8.19 ± 2.54 vs 7.62 ± 2.31, 5.15 ± 1.58 vs 4.94 ± 1.47, 11.74 ± 3.63 vs 10.92 ± 3.32, 4.42 ± 0.50 vs 3.90 ± 0.57, respectively, P < 0.001) analysis revealed significant decreases. No significant differences in clinical outcomes were observed based on nutritional status.
Paediatric β-TM patients undergoing HSCT exhibit significant changes in nutrition status and body composition, emphasizing the need for focused attention on malnourished children who are more prone to diminished nutritional status. Comprehensive BIA aids in understanding the impact, urging consideration for extended follow-up and larger cohorts in future research.
本回顾性研究采用生物电阻抗分析（BIA）评估小儿β地中海贫血（β-TM）患者造血干细胞移植（HSCT）前后的营养状况和身体成分变化，并探讨其与HSCT结局的关系。
对40例接受异基因HSCT的小儿β-TM患者进行评估，测量其营养状况、人体测量参数（包括体重指数（BMI）、体重和身高）以及HSCT前后的身体成分参数，重点关注BIA测量值，包括细胞内液（ICW）、细胞外液（ECW）、脂肪量（FAT）、去脂体重（FFM）、骨骼肌量（SMM）、瘦软组织量（SLM）、体脂百分比（PBF）、身体细胞量（BCM）、相位角（PA）和肌肉平衡。分析HSCT后的临床结局，包括急性移植物抗宿主病（aGVHD）、植入时间、口腔黏膜炎（OM）、肝窦阻塞综合征（SOS）以及与HSCT后营养状况相关的腹泻。
HSCT后，28.21%的患者营养状况下降，HSCT前消瘦的患者中有71.43%营养状况下降，显著高于正常组（18.75%，P = 0.012）。人体测量变化包括体重显著减轻（87.5%，22.15±7.46 vs 20.74±6.57，P < 0.001）和BMI降低（90%，15.19±1.70 vs 14.05±1.48，P < 0.001）。身体成分参数分析显示，FFM、SMM、SLM、ICW、ECW、BCM和PA均显著降低（分别为18.26±5.71 vs 17.27±5.19、8.68±3.30 vs 7.93±3.02、17.11±5.28 vs 16.06±4.84、8.19±2.54 vs 7.62±2.31、5.15±1.58 vs 4.94±1.47、11.74±3.63 vs 10.92±3.32、4.42±0.50 vs 3.90±(0.57)，P < 0.001）。基于营养状况，临床结局未观察到显著差异。
接受HSCT的小儿β-TM患者营养状况和身体成分出现显著变化。这强调需要特别关注营养不良且更易出现营养状况下降的儿童。全面的BIA有助于了解其影响，促使在未来研究中考虑延长随访时间并纳入更大的队列。
