Pre-transplant arm muscle area: a simple measure to identify patients at risk

Support Care Cancer. 2015 Nov;23(11):3385-91. doi: 10.1007/s00520-015-2850-2. Epub 2015 Jul 21.

Abstract

Purpose: This study aims to explore parameters of nutritional assessment and food intake as predictors of clinical outcomes after hematopoietic stem cell transplant (HSCT).

Methods: The study was conducted retrospectively with 56 adult patients undergoing allogeneic HSCT. Energy and protein daily intake were used to calculate the energy and protein cumulative deficit. The nutritional assessment tools were weight, body mass index (BMI), triceps skinfold (TSF), and arm muscle area (AMA) before HSCT and after HSCT.

Results: Food intake decreased immediately after the transplant and the energy and protein cumulative deficit increased during hospitalization (p < 0.01). Almost 70 % of patients had severe weight loss (greater than 5 %), and the average percentage of weight loss was 8.5 ± 3.9 %. BMI and weight loss percentage were not correlated with the presence of acute graft versus host disease (GVHD) and mortality within 180 days in this population. On the other hand, correlation was found between the initial (pre-HSCT) AMA equal to or below the 15th percentile, with the presence of acute GVHD (p = 0.024), and mortality within 180 days after HSCT (p = 0.010).

Conclusions: The AMA measured pre-HSCT showed to be a potential predictor of acute GVHD and mortality up to 180 days after transplant in adult patients.

Keywords: Body composition; Food intake; Hematopoietic stem cell transplantation; Nutritional assessment.

MeSH terms

  • Adolescent
  • Adult
  • Arm / physiology
  • Body Mass Index
  • Body Weight
  • Eating
  • Female
  • Graft vs Host Disease / epidemiology*
  • Graft vs Host Disease / mortality
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Male
  • Middle Aged
  • Muscle, Skeletal / physiology*
  • Nutrition Assessment
  • Retrospective Studies
  • Treatment Outcome
  • Upper Extremity / physiology
  • Young Adult