Oral protein intake and the risk of acute graft-versus-host disease after allogeneic marrow transplantation.
The possibility that antigenically active protein macromolecules affect the risk of developing acute graft-versus-host disease (aGVHD) was investigated in a cohort of patients who underwent allogeneic marrow transplantation for hematologic malignancy (n = 575). Daily records of food intake from transplant through discharge or death were evaluated for grams of total protein and summed over consecutive 4-day intervals. The day of onset of aGVHD was partitioned into 4-day time intervals such that assessments of food intake preceded onset of aGVHD by 3-6 days. Acute GVHD developed in 308 (54%) patients. The cumulative incidence of aGVHD among patients eating any amount of protein was lower (4-13%) than that of patients not eating protein (8-19%) for each of the time intervals through day 21 post-transplant; the relative risk associated with protein intake, adjusted for patient and transplant characteristics that are correlated with the occurrence of aGVHD, ranged from 0.23 (95% confidence interval (CI) 0.09, 0.63) to 0.83 (CI 0.46, 1.51). A proportional hazards regression analysis, using protein intake as a time-dependent covariate, confirmed these results. The findings of this study provide no support for the hypothesis that intake of protein-containing foods during the first 3 weeks after marrow transplantation increases the risk of aGVHD.
Cheney
C L
CL
Division of Clinical Research, Fred Hutchinson Cancer Research Center, WA 98104.
Weiss
N S
NS
Fisher
L D
LD
Sanders
J E
JE
Davis
S
S
Worthington-Roberts
B
B
D000284:Administration, Oral; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D004044:Dietary Proteins / Q000008:administration & dosage / Q000009:adverse effects* / Q000378:metabolism; D005260:Female; D006086:Graft vs Host Disease / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D012044:Regression Analysis; D012307:Risk Factors; D013997:Time Factors; D014184:Transplantation, Homologous
D004044:Dietary Proteins