title: Weight Loss and Decrease of Body Mass Index during Allogeneic Stem Cell Transplantation Are Common Events with Limited Clinical Impact.
abstract: OBJECTIVE
  Weight loss in cancer patients has been attributed with significant morbidity and mortality. During allogeneic stem cell transplantation (SCT), oral nutrition is often hampered and hence total parenteral nutrition (TPN) is necessary. We therefore investigated the course of weight during stem cell transplantation and the clinical consequences of weight change.
  
  
  METHODS
  180 consecutive patients who received allogeneic SCT between January 2010 and December 2011 at our center were analyzed for weight loss, laboratory and clinical parameters.
  
  
  RESULTS
  During SCT, a median decrease of 6.6% of body mass index (BMI) was observed for the whole population (from 25.3 at admission to 23.6 at discharge), and a 1.6fold increase of malnutrition despite use of TPN (28.3% to 45.0%). 55.6% of patients experienced a significant weight loss of ≥5% with a median decrease of 9.2% in BMI. Serum levels of albumin, total protein and cholesterol rapidly decreased during conditioning therapy. After a median of 2.4 years, the median BMI was still only 23.4 (not different from discharge). However, we did not observe a meaningful difference in side effects and survival between patients that did or did not lose weight.
  
  
  CONCLUSIONS
  Weight loss is commonly observed during allogeneic SCT despite TPN, but the clinical consequences thereof seem limited: we observed no significant impact on patients with a decrease ≥ 5% in BMI on transplant outcome, side effects or survival.
authors.affiliation: Department of Internal Medicine III, Klinikum der Universität München, Munich, Germany.
authors.forename: Christina T
authors.initials: CT
authors.lastname: Rieger
authors.affiliation: Department of Internal Medicine III, Klinikum der Universität München, Munich, Germany.
authors.forename: Isabel
authors.initials: I
authors.lastname: Wischumerski
authors.affiliation: Department of Internal Medicine I, Krankenhaus der Barmherzigen Brüder, Munich, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Rust
authors.affiliation: Department of Internal Medicine III, Klinikum der Universität München, Munich, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Fiegl
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D033581:Stem Cell Transplantation; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult