Nutritional assessment with different tools in leukemia patients after hematopoietic stem cell transplantation

Correct nutritional assessment is essential for leukemia patients after hematopoietic stem cell transplantation (HSCT). This study aimed to investigate the best nutritional assessment method for leukemia patients after HSCT, and find the possible nutritional risk of the patients during the transplantation process in order to intervene in the patients with nutritional risks and undernourished patients timely, so that the entire transplantation process could be successfully completed.

A prospective study was performed in 108 leukemia patients after HSCT, and different nutritional assessment methods, including nutritional risk screening 2002 (NRS2002), mini nutritional assessment (MNA), subjective globe assessment (SGA) and malnutritional universal screening tools (MUST), were used. The associations between nutritional status of these patients and nutritional assessment methods were analyzed.

A total of 108 patients completed SGA, and 99 patients completed NRS2002, MNA and MUST. During the treatment process, 85.2% of the patients lost weight, wherein, 50% lost weight greater than 5%, and 42.6% had significantly reduced food intake. For nutritional risk assessment, the positive rates of NRS2002, MNA and MUST were 100%, 74.7% and 63.6%, respectively. There was a significant difference (P<0.05) among the positive rates of NRS2002, MNA and MUST. In undernutrition assessment, the positive rate of SGA (83.3%) was significantly higher than that of MNA (17.2%) (P<0.05), and the incidence rate of nutritional risk among leukemia patients ≤30 years old was greater than that of patients >30 years old (P<0.05).

Patients with leukemia were in poor nutritional status during and after HSCT. The leukemia patients ≤30 years old had a greater incidence rate of nutritional risk. As nutritional risk screening tool, the specificity of NRS2002 is not high, but it can be used for evaluating nutritional deficiencies. MNA is a good nutritional risk screening tool, but not an adequate tool for nutritional assessment. If assessment of undernutrition is necessary, the combination of all these screening tools and clinical laboratory indicators should be applied to improve accuracy.