title: Changes in nutritional status, body composition, quality of life, and physical activity levels of cancer patients undergoing autologous peripheral blood stem cell transplantation.
abstract: OBJECTIVE
  This pilot exploratory study aimed to describe the changes in nutritional status, body composition, quality of life (QoL), and physical activity levels (PAL) of cancer patients undergoing high-dose conditioning and autologous peripheral blood stem cell transplantation (PBSCT) at pre-admission, hospital discharge, and at 100 days post-transplantation, and to examine if changes in these parameters are interrelated.
  
  
  METHODS
  Twenty-four patients (56.2 ± 12.9 years; 7 females, 17 males) were recruited from an Australian transplant center. Assessment was prospectively conducted at pre-admission, hospital discharge, and 100 days post-transplantation using the scored patient-generated subjective global assessment, air displacement plethysmography, EORTC QLQ-C30 (version 3), and the international physical activity questionnaire.
  
  
  RESULTS
  At discharge, nutritional status deteriorated (patient-generated subjective global assessment (PG-SGA) median, +8.0; interquartile range, 6.0-13.0; p < 0.001) and the number of malnourished patients increased (n = 8/23; p = 0.023). Patients experienced significant loss of lean body mass (LBM; -2.2 kg, CI 95% -3.0, -1.4; p < 0.001), and decrease in QoL (-10.6, CI 95% -24.1, 2.9; p = 0.117); the proportion of patients with high PAL decreased (p = 0.012). By 100 days post-transplantation, all patients were well-nourished; however, LBM remained lower -1.0 kg (CI 95% -1.9, -0.1; p = 0.028). Change in nutritional status (PG-SGA score) was associated with weight (r = -0.46; p = 0.039) and fat mass (r = -0.57; p = 0.013). Change in QoL was associated with nutritional reservoir (i.e., fat; r = 0.54; p = 0.024); QoL was consistently higher for patients with high PAL.
  
  
  CONCLUSIONS
  High-dose conditioning and autologous PBSCT is associated with deterioration in nutritional status, QoL and PAL, with LBM remaining below baseline levels at 100 days post-transplantation. A nutrition and exercise intervention program post-hospital discharge may be beneficial for these patients.
authors.affiliation: Centre for Dietetics Research, School of Human Movement Studies, The University of Queensland, Brisbane, 4072, Australia. y.hung@uq.edu.au
authors.forename: Yun-Chi
authors.initials: YC
authors.lastname: Hung
authors.forename: Judith
authors.initials: J
authors.lastname: Bauer
authors.forename: Pamela
authors.initials: P
authors.lastname: Horsley
authors.forename: Mary
authors.initials: M
authors.lastname: Waterhouse
authors.forename: John
authors.initials: J
authors.lastname: Bashford
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Isenring
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D001823:Body Composition; D001835:Body Weight; D005260:Female; D006304:Health Status; D019337:Hematologic Neoplasms / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009752:Nutritional Status; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D010865:Pilot Projects; D011788:Quality of Life; D011795:Surveys and Questionnaires; D019172:Transplantation Conditioning / Q000009:adverse effects