title: Reduced nutritional status among multiple myeloma patients during treatment with high-dose chemotherapy and autologous stem cell support.
abstract: OBJECTIVE
  Multiple myeloma (MM) ranks among the most frequent blood cancers in adults. Optimal treatment consists of high-dose chemotherapy and autologous stem cell transplantation. Health-related quality of life (HRQoL) is reduced before, during, and after therapy. Several HRQoL items are associated with nutritional health, e.g., nausea/vomiting, appetite loss and fatigue. It is unknown whether nutritional status in MM is affected by treatment. Hence we assessed nutritional status before, during and (1/2) year after treatment-start.
  
  
  METHODS
  We applied anthropometry (height, weight, hand-grip strength, triceps skinfold) and plasma concentrations of biomarkers to assess nutritional status. HRQoL was determined with the EORTC QLQ-C30 questionnaire.
  
  
  RESULTS
  The anthropometrical parameters all decreased (p<0.05) during treatment, but were restored at the end of the observation period. Albumin and the fat-soluble vitamins D and E followed a similar pattern, whereas transferrin and vitamin A were unchanged (p>0.05). Interestingly, markers of thyroid function declined and remained low (p<0.05) even 6 months after start of therapy. Nutrition-associated symptoms used as markers of HRQoL worsened during therapy, but returned to pre-therapy levels.
  
  
  CONCLUSIONS
  Intensive therapy in MM is associated with a decline in both nutritional status and health-related quality of life.
authors.affiliation: Department of Hematology, Oslo University Hospital, Ullevaal, Oslo, Norway. poiversen@hotmail.com
authors.forename: Per Ole
authors.initials: PO
authors.lastname: Iversen
authors.forename: Finn
authors.initials: F
authors.lastname: Wisløff
authors.forename: Nina
authors.initials: N
authors.lastname: Gulbrandsen
mesh_terms: D000328:Adult; D000886:Anthropometry; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects* / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D049628:Body Size; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy*; D009752:Nutritional Status / Q000187:drug effects*; D011788:Quality of Life / Q000523:psychology; D033581:Stem Cell Transplantation / Q000009:adverse effects; D011795:Surveys and Questionnaires; D013997:Time Factors; D014182:Transplantation, Autologous
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers