title: Longitudinal follow-up of body composition in hematopoietic stem cell transplant patients.
abstract: Patients with hematological malignancies are well nourished prior to allogeneic hematopoietic stem cell transplantation (HSCT). HSCT and associated complications can affect body composition. The study evaluated cross-sectionally the prevalence and longitudinally the changes in lean body mass index (LBMI) in HSCT patients. Patients (n=82) were classified as normal or low LBMI. Logistic regression analyses were used to estimate odds ratios (OR) for low vs normal LBMI, between healthy volunteers and patients; for limited or extensive vs no chronic graft-versus-host-disease (GVHD); and for decreased (Karnofsky <80) vs normal functional status (>80). Patients were significantly more likely to have low LBMI at 6, 12 months, 2-3, 4-6 and >6 years than volunteers. In all, 38% of patients were below pre-HSCT LBMI at 4-6 years post-HSCT. Low LBMI was significantly associated with steroid treatment (OR 2.6, confidence intervals (CI) 1.3-5.2, P=0.008); limited (OR 5.5, CI 1.7-18.5, P=0.005) or extensive chronic GVHD (OR 20.3, CI 5.7-71.6, P<0.001); and decreased performance status (Karnofsky scores of < or =80) (OR 2.7, CI 1.3-5.9, P=0.01). Patients were more likely to have low LBMI than volunteers. Chronic GVHD and low performance status were associated with low LBMI; thus, complications and/or treatment increase the likelihood of low LBMI.
authors.affiliation: Division of Clinical Nutrition, Geneva University Hospital, Geneva, Switzerland.
authors.forename: U G
authors.initials: UG
authors.lastname: Kyle
authors.forename: Y
authors.initials: Y
authors.lastname: Chalandon
authors.forename: R
authors.initials: R
authors.lastname: Miralbell
authors.forename: V L
authors.initials: VL
authors.lastname: Karsegard
authors.forename: D
authors.initials: D
authors.lastname: Hans
authors.forename: A
authors.initials: A
authors.lastname: Trombetti
authors.forename: R
authors.initials: R
authors.lastname: Rizzoli
authors.forename: C
authors.initials: C
authors.lastname: Helg
authors.forename: C
authors.initials: C
authors.lastname: Pichard
mesh_terms: D001823:Body Composition; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D016022:Case-Control Studies; D006086:Graft vs Host Disease; D019337:Hematologic Neoplasms / Q000150:complications / Q000378:metabolism / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D017567:Karnofsky Performance Status; D008137:Longitudinal Studies; D016017:Odds Ratio; D012189:Retrospective Studies; D013256:Steroids / Q000009:adverse effects / Q000627:therapeutic use; D014184:Transplantation, Homologous
chemical_list: D013256:Steroids