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Published on: September 6, 2017
Nutritional and Body Composition Changes in Paediatric β-Thalassemia Patients Undergoing Hematopoietic Stem Cell
Luyang Zhang1, Li Wang2, Jiewen Long1
1Department of Haematology and Oncology, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, 518000, People's Republic of China.
Insights
Hematopoietic stem cell transplantation (HSCT) significantly impacts nutritional status and body composition in paediatric β-thalassemia (β-TM) patients. Malnourished children require focused attention post-HSCT due to increased risk of diminished nutritional status.
Area of Science:
- Paediatric Haematology
- Nutritional Science
- Transplantation Medicine
Background:
- Paediatric β-thalassemia (β-TM) patients often face nutritional challenges.
- Hematopoietic stem cell transplantation (HSCT) is a curative treatment for β-TM, but can affect nutritional status.
- Understanding body composition changes post-HSCT is crucial for patient outcomes.
Purpose of the Study:
- To evaluate nutritional status and body composition changes in paediatric β-TM patients before and after HSCT.
- To explore the relationship between these changes and HSCT outcomes.
- To utilize bioelectrical impedance analysis (BIA) for comprehensive assessment.
Main Methods:
- Retrospective study of 40 paediatric β-TM patients undergoing allogeneic HSCT.
- Assessment of nutritional status, anthropometric parameters (BMI, weight, height), and body composition using BIA pre- and post-HSCT.
- Analysis of clinical outcomes including graft-vs-host disease, engraftment, mucositis, and diarrhoea.
Main Results:
- Significant decreases in weight, BMI, fat-free mass (FFM), skeletal muscle mass (SMM), and body cell mass (BCM) were observed post-HSCT.
- 28.21% of patients experienced diminished nutritional status after HSCT, with higher rates in those previously malnourished.
- No significant differences in clinical outcomes were found based on nutritional status post-HSCT.
Conclusions:
- Paediatric β-TM patients undergoing HSCT experience significant nutritional and body composition alterations.
- Malnourished children require targeted nutritional support and monitoring post-HSCT.
- Bioelectrical impedance analysis (BIA) is valuable for assessing these changes, suggesting a need for extended follow-up and larger studies.
Objective:
This retrospective study evaluated nutritional status and body composition changes in paediatric β-thalassemia (β-TM) patients before and after hematopoietic stem cell transplantation (HSCT), using bioelectrical impedance analysis (BIA), and explored their relationship with HSCT outcomes.
Methods:
A cohort of 40 paediatric β-TM patients undergoing allogeneic HSCT was assessed for their nutritional status, anthropometric parameters, including body mass index (BMI), weight, and height, and body composition parameters pre-and post-HSCT, focusing on BIA measurements, including intracellular water (ICW), extracellular water (ECW), fat mass (FAT), fat-free mass (FFM), Skeletal Muscle Mass (SMM), soft Lean Mass (SLM), percent body fat (PBF), Body Cell Mass (BCM), Phase angle (PA) and muscle balance pre- and post-HSCT. Post-HSCT clinical outcomes, including acute graft-vs-host disease (aGVHD), engraftment time, oral mucositis (OM), sinusoidal obstruction syndrome (SOS), and diarrhoea in relation to nutrition status after HSCT were analysed.
Results:
After HSCT, 28.21% experienced diminished nutritional status, with 71.43% of those who were wasting before HSCT showing diminished nutritional status, significantly higher than the normal group (18.75%, P = 0.012). Anthropometric changes included significant weight reduction (87.5%, 22.15 ± 7.46 vs 20.74 ± 6.57, P < 0.001) and BMI decrease (90%, 15.19 ± 1.70 vs 14.05 ± 1.48, P < 0.001). Body composition parameters, which are FFM, SMM, SLM, ICW, ECW, BCM, and PA (18.26 ± 5.71 vs 17.27 ± 5.19, 8.68 ± 3.30 vs 7.93 ± 3.02, 17.11 ± 5.28 vs 16.06 ± 4.84, 8.19 ± 2.54 vs 7.62 ± 2.31, 5.15 ± 1.58 vs 4.94 ± 1.47, 11.74 ± 3.63 vs 10.92 ± 3.32, 4.42 ± 0.50 vs 3.90 ± 0.57, respectively, P < 0.001) analysis revealed significant decreases. No significant differences in clinical outcomes were observed based on nutritional status.
Conclusion:
Paediatric β-TM patients undergoing HSCT exhibit significant changes in nutrition status and body composition, emphasizing the need for focused attention on malnourished children who are more prone to diminished nutritional status. Comprehensive BIA aids in understanding the impact, urging consideration for extended follow-up and larger cohorts in future research.
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