title: Nutritional risk in allogeneic stem cell transplantation: rationale for a tailored nutritional pathway.
abstract: Hematopoietic stem cell transplantation carries nutrition-related risks. Therefore, nutritional therapy needs to be initiated before transplantation even takes place. We assessed nutritional risk among patients who underwent allogeneic stem cell transplantation. We assessed nutrient supply (calorie supply and protein supply) by chart review. Assessments were made from the pretreatment phase of transplantation to after the end of parenteral nutrition in 51 patients who underwent allogeneic stem cell transplantation at Shizuoka Cancer Center between 2007 and 2012. We compared nutrition-related adverse events and parameters between two groups: those in whom % loss of body weight was ≥7.5 and those in whom % loss of body weight was <7.5. A correlation was observed between changes in weight and skeletal muscle mass (r = 0.89; P < 0.0001). A weak correlation was observed between % loss of body weight and nutrient supply of calories (r = 0.517; P = 0.0001). There were significant differences between the % loss of body weight ≥7.5 group and the % loss of body weight <7.5 group in the following variables: % loss of body weight, nutrient supply from calories and protein; orally ingested nutrient supply from calories and protein; start day of oral intake; and acute graft-versus-host disease. Orally ingested calories were negatively correlated with nutrition-related adverse events in both groups. Early and customized nutritional intervention may be optimal for all patients who undergo allogeneic stem cell transplantation to ameliorate body weight loss associated with nutrition-related adverse events.
authors.affiliation: Division of Nutrition, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Aoyama
authors.affiliation: Division of Hematology & Stem Cell Transplantation, Kagawa University Hospital, Ikenobe Miki Town, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Imataki
authors.affiliation: Division of Biostatistical Chief, Clinical Research Promotion Unit, Clinical Research Center, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Keita
authors.initials: K
authors.lastname: Mori
authors.affiliation: Division of Hematology & Stem Cell Transplantation, Shizuoka Cancer Center, 1007 Shimonagakubo, Naga-izumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
authors.forename: Kanako
authors.initials: K
authors.lastname: Yoshitsugu
authors.affiliation: Division of Hematology & Stem Cell Transplantation, Shizuoka Cancer Center, 1007 Shimonagakubo, Naga-izumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Fukaya
authors.affiliation: Division of Hematology & Stem Cell Transplantation, Shizuoka Cancer Center, 1007 Shimonagakubo, Naga-izumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
authors.forename: Ikue
authors.initials: I
authors.lastname: Okamura
authors.affiliation: Division of Hematology & Stem Cell Transplantation, Shizuoka Cancer Center, 1007 Shimonagakubo, Naga-izumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
authors.forename: Terukazu
authors.initials: T
authors.lastname: Enami
authors.affiliation: Division of Hematology & Stem Cell Transplantation, Shizuoka Cancer Center, 1007 Shimonagakubo, Naga-izumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
authors.forename: Raine
authors.initials: R
authors.lastname: Tatara
authors.affiliation: Division of Hematology & Stem Cell Transplantation, Shizuoka Cancer Center, 1007 Shimonagakubo, Naga-izumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan. t.ikeda@scchr.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ikeda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001835:Body Weight / Q000502:physiology*; D002149:Energy Intake / Q000502:physiology*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000502:physiology*; D012307:Risk Factors; D014184:Transplantation, Homologous / Q000009:adverse effects / Q000639:trends; D055815:Young Adult
keywords: Allogeneic blood stem cell transplantation; Bioelectrical impedance analysis; Nutrition-related adverse events; Nutritional pathway