title: Clinical impact of sarcopenia and relevance of nutritional intake in patients before and after allogeneic hematopoietic stem cell transplantation.
abstract: OBJECTIVE
  We conducted a retrospective study to evaluate the effect of rehabilitation on minimizing sarcopenia during hematopoietic stem cell transplantation (HSCT) therapy.
  
  
  METHODS
  We developed a protocol to test for retention of physical function during HSCT. Muscle strength, muscle circumference, and muscle function before and after HSCT were measured. Consecutive patients with hematological malignancies who underwent HSCT treatment were recruited in this research.
  
  
  RESULTS
  We included 34 patients (16 females, 18 males; median age, 51.5 years). Bodyweight significantly decreased after HSCT (p < 0.001). Nine females and three males had sarcopenia prior to allogeneic HSCT. After HSCT, bilateral hand grip strength and bilateral knee extensor strength decreased significantly. The total caloric intakes for pre-conditioning, during preparation regimen, and after transplant were 1709, 1024, and 1445 kcal, respectively, and were significantly attenuated in the post-transplant period. Serum albumin was significantly decreased in the final period. Conversely, C-reactive protein was slightly but significantly increased across the transplantation process. Multivariate regression analysis revealed that oral caloric intake after the transplantation period and sex were significantly related to muscle weakness (p = 0.033 and 0.036, respectively).
  
  
  CONCLUSIONS
  Sarcopenia during HSCT was affected by oral caloric intake during the preparation regimen and after transplantation. Physical therapy in conjunction with nutritional therapy may help prevent weakness in HSCT recipients.
authors.affiliation: Department of Rehabilitation, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Shouichi
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Division of Hematology and Stem Cell Transplantation, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Imataki
authors.affiliation: Division of Clinical Nutrition, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Atsuo
authors.initials: A
authors.lastname: Kitaoka
authors.affiliation: Department of Rehabilitation, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Fujioka
authors.affiliation: Division of Clinical Nutrition, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Etsuyo
authors.initials: E
authors.lastname: Hanabusa
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Ohbayashi
authors.affiliation: Division of Hematology and Stem Cell Transplantation, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Makiko
authors.initials: M
authors.lastname: Uemura
authors.affiliation: Department of Orthopedic Surgery, Sanuki Municipal Hospital, Kagawa, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Arima
authors.affiliation: Department of Orthopedic Surgery, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan. sanutetu@med.kagawa-u.ac.jp.
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004435:Eating / Q000502:physiology*; D005260:Female; D018737:Hand Strength; D019337:Hematologic Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D009752:Nutritional Status / Q000502:physiology; D011379:Prognosis; D012189:Retrospective Studies; D055948:Sarcopenia / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control; D014184:Transplantation, Homologous; D055815:Young Adult
keywords: Hematopoietic stem cell transplantation; Muscle weakness; Nutrition therapy; Rehabilitation; Sarcopenia