Changes in body composition in children with acute graft-versus-host disease within the first 100 days after

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Yi Feng1, Li-Ya Pan1, Li-Yuan Shen1

  • 1Department of Clinical Nutrition, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China.

European Journal of Clinical Nutrition
|December 23, 2017
PubMed

Insights

Pediatric patients with acute graft-versus-host-disease (aGVHD) after stem cell transplant show increased body mass index and fat mass, alongside decreased muscle mass. Glucocorticoids and mucositis significantly impact these changes.

Area of Science:

  • Pediatric Hematology
  • Transplantation Immunology
  • Body Composition Analysis

Background:

  • Acute graft-versus-host-disease (aGVHD) is a major complication following hematopoietic stem cell transplantation (HSCT).
  • Understanding body composition changes in pediatric HSCT recipients with aGVHD is crucial for managing post-transplant outcomes.

Purpose of the Study:

  • To investigate the dynamic changes in body composition among pediatric patients experiencing aGVHD during the initial 100 days post-HSCT.
  • To identify key factors influencing these body composition alterations.

Main Methods:

  • A cohort of 55 pediatric HSCT patients was stratified into aGVHD and non-aGVHD groups.
  • Body composition parameters including BMI Z-scores, arm muscle area index, fat mass index, and fat-free mass index were measured at baseline and at 30, 60, and 100 days post-transplant.
  • Correlative analyses were performed to identify factors affecting body composition.

Main Results:

  • The aGVHD group exhibited a significant increase in BMI Z-scores by day 30 post-HSCT compared to the non-aGVHD group.
  • Arm muscle area index consistently decreased in the aGVHD group throughout the 100-day period.
  • Fat-free mass index was lower in the aGVHD group at 60 and 100 days post-HSCT, with glucocorticoid treatment and mucositis identified as significant influencing factors.

Conclusions:

  • Early post-HSCT body composition changes in pediatric aGVHD patients are characterized by reduced lean mass and increased fat mass.
  • Glucocorticoid therapy and the presence of mucositis are critical determinants of body composition shifts in this patient population.
Abstract

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