Nutrition impact symptoms and short-term outcomes in patients with hematological cancers

Malnutrition remains common in patients with hematological diseases, where nutrition impact symptoms (NIS) may impair dietary intake and consequently clinical outcomes. However, current tools often assess either symptom presence or intake limitation. This study aimed to determine the prevalence of NIS and discrepancies between NIS presence and intake limitation, assess changes following stem cell treatment initiation, and explore NIS associations with weight change and short-term mortality.

Observational study with a cross-sectional baseline assessment and longitudinal follow-up, including patients with hematological cancer referred to dietetic care. Baseline cross-sectional analyses described NIS (presence [NIS-P] and limiting intake [NIS-L] in two referral groups (stem cell vs. selectively referred patients with other treatments). In patients undergoing stem cell treatment, NIS were reassessed ∼1 week after initiation to evaluate within-patient changes. In a subset with a 2-month follow-up, associations between baseline NIS, weight change, and mortality were explored for the combined population.

Eighty patients were included in the analysis. Median NIS-points in the total population were 15.5 [IQR 0; 26]. In the group that received stem cell treatment, total NIS-points increased significantly after initiation of treatment with an increase in median from 0 to 19 points (p = 0.002). The relationship between baseline NIS and short-term weight change could not be reliably assessed, likely reflecting methodological constraints rather than a true absence of association. However, higher baseline NIS-points were observed among patients who died within 2 months in the unadjusted analysis (all p ≤ 0.05).

NIS were prevalent, with a consistent discrepancy between NIS-P and NIS-L, indicating that symptom presence alone does not reflect nutritional vulnerability. Initiation of stem cell treatment was associated with increased NIS burden. Higher symptom burden was observed among patients who died during follow-up; however, causal inferences cannot be drawn.