Which parameters of nutritional status should we choose for nutritional assessment during hematopoietic stem cell transplantation?

Since changes in nutritional indices after hematopoietic stem cell transplantation (HSCT) have not been well studied, there is no definition of risk factors for the development of malnutrition, and the inception of total parenteral nutrition (TPN). We sought to analyze changes in nutritional status parameters and acute phase protein levels as qualifications for TPN. Nutritional status was assessed in 54 patients during autologous (n = 30) on allogeneic (n = 24) transplantations. Eight of 15 patients who had to be treated with TPN, needed prolonged hospitalization (>5 weeks). We assessed biochemical and anthropometric indices of nutritional status, body fat and resting energy expenditure, and acute phase protein levels on the day before starting a conditioning regimen, after chemotherapy completion, and every 7 days until engraftment, which was at least three times after stem cell infusion. Wilcoxon test and canonical analysis were used for statistical analyses. The measurement of body weight and retinol binding protein or transferrin may be useful for nutritional assessment during autologous or allogeneic HSCT, respectively. Prealbumin level, measured 8 days after the end of the conditioning regimen was helpful to make a decision about starting TPN.

Biochemical indices for the assessment of nutritional status during hematopoietic stem cell transplantation: are they worth using? A single center experience.

Hematopoietic stem cell transplantation (HSCT) is being used increasingly in an attempt to cure many hematological disorders, solid tumors and autoimmune diseases. One of the major challenges in the post-transplant period is nutrition. The purpose of this investigation was to assess changes in the biochemical indices of nutritional status during HSCT and compare them with acute-phase protein levels to find the best parameters for nutritional support qualification. Nutritional status was assessed in 54 patients during autologous (30 cases) and allogeneic (24 cases) transplantation. Fifteen patients had to be treated with total parenteral nutrition (TPN), eight of them needing prolonged hospitalization. All nutritional indices and acute-phase protein levels were evaluated during the day before the beginning of conditioning regimen, after chemotherapy completion and every 7 days until engraftment, at least three times after stem cells infusion. Wilcoxon test and canonical analysis were used for statistical analyses. The measurement of retinol-binding protein and transferrin can be useful for nutritional assessment during autologous and allogeneic HSCT, respectively. Prealbumin level, measured 8 days after the end of conditioning regimen, is helpful in making a decision about starting TPN.

Nutritional assessment during allogeneic hematopoietic stem cell transplantation: single centre experience.

PURPOSE: The aim of this study was to analyse the changes in several parameters of nutritional status, acute phase proteins' levels and evaluation of the usefulness of the investigated parameters for qualification for total parenteral nutrition (TPN) during allogeneic hematopoietic stem cell transplantations (HSCT). PATIENTS AND METHODS: The nutritional status was assessed in 24 patients. Biochemical and anthropometric indices of nutritional status as well as body fat and resting energy expenditure were assessed. The levels of acute phase proteins were estimated at the same time. All parameters were evaluated during the day before starting a conditioning regimen, after chemotherapy completion and every 7 days until engraftment, at least 3 times after stem cells infusion. Wilcoxon test and canonical analysis were used for statistical analyses. RESULTS: The measurement of body weight and estimation of transferrin levels can be useful for the nutritional assessment during allogeneic HSCT from sibling donors. Prealbumin level, measured 8 days after the conditioning regimen, can be helpful to make a decision for TPN. Statistically significant differences were found in the levels of biochemical indices of nutritional status and in resting energy expenditure (REE) between patients who received stem cells from the bone marrow and from peripheral blood. Values were lower and decreased earlier after transplantation when bone marrow was the source of HSCT. CONCLUSION: These findings may indicate that the influence of transplantation procedures over patients' nutritional status is bigger when bone marrow is used as a source of hematopoietic stem cells.