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急性白血病患者营养状况的评估及其预后影响:一项叙述性综述

Evaluation and Prognostic Impact of Nutrition in Patients with Acute Leukemia: A Narrative Review.

作者信息

Fuchs-Tarlovsky Vanessa, Alvarez-Altamirano Karolina, Vedrenne-Gutiérrez Fernand

机构信息

Servicio de Nutrición Clínica, Hospital General de México, Dr Balmis 148, Colonia Doctores, Delegación Cuauhthemoc, Mexico City, 06720, Mexico.

School of Medicine and Health Sciences, Universidad Anáhuac México, Huixquilucan, Estado de México, México.

出版信息

Curr Oncol Rep. 2025 May;27(5):625-633. doi: 10.1007/s11912-025-01671-5. Epub 2025 Apr 8.

Abstract

PURPOSE OF THIS REVIEW

Acute leukemia (AL) is a hematological neoplasm with rapid progression that affects nutritional status of patients. Assessing nutrition in patients with haematological malignancies poses challenges due to the rapid progression of the disease, the variety of methods for evaluating malnutrition. In this review we will provide evidence of the need of early malnutrition diagnosis thru timely assessment and the implications of malnutrition in patients evolution in patients with AL.

RECENT FINDINGS

The prevalence of malnutrition ranging from 15 to 26.5% among patients with AL. It is well known that inflammation and cytokine production have been recognized as potential mechanisms of CCS in hematologic malignancies. Regardless of the mechanism underlying Cancer Cachexia Syndrome (CCS) in AML, patients undergoing conditioning chemotherapy and during transplant or antineoplastic treatment. In addition to this, patients with AL undergoing chemotherapy frequently face two main challenges: oral mucositis (OM) and neutropenic colitis (NC). Both conditions challenge nutrition intake and nutrients absorption which make them more susceptible to have nutritional deficits. Malnutrition in patients with acute leukemia face a higher risk of therapy failure, increased rates of relapse, and higher mortality rates. Nutritional status impact patient's prognosis in many ways, malnutrition increases risk of antineoplastic treatment toxicities, hospital stay, and cost, as well reduces quality of life and this condition worsens patient's prognosis.

摘要

本综述的目的

急性白血病(AL)是一种进展迅速的血液肿瘤,会影响患者的营养状况。由于疾病进展迅速以及评估营养不良的方法多样,评估血液系统恶性肿瘤患者的营养状况具有挑战性。在本综述中,我们将通过及时评估提供早期营养不良诊断必要性的证据,以及营养不良对急性白血病患者病情发展的影响。

最新发现

急性白血病患者中营养不良的患病率在15%至26.5%之间。众所周知,炎症和细胞因子产生已被认为是血液系统恶性肿瘤中癌症恶病质综合征(CCS)的潜在机制。无论急性髓系白血病(AML)中癌症恶病质综合征(CCS)的潜在机制如何,接受预处理化疗的患者以及移植或抗肿瘤治疗期间的患者都会出现。除此之外,接受化疗的急性白血病患者经常面临两个主要挑战:口腔黏膜炎(OM)和中性粒细胞减少性结肠炎(NC)。这两种情况都会对营养摄入和营养吸收造成挑战,使患者更容易出现营养缺乏。急性白血病患者的营养不良面临更高的治疗失败风险、更高的复发率和更高的死亡率。营养状况在许多方面影响患者的预后,营养不良会增加抗肿瘤治疗毒性、住院时间和费用的风险,还会降低生活质量,这种情况会使患者的预后恶化。

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