Related Experiment Videos
Increase in height during the first year after bone marrow transplantation reflecting nutritional status of children
M Taskinen1, U M Saarinen-Pihkala
1Hospital for Children and Adolescents, University of Helsinki, Finland.
Insights
Pre-transplant nutritional status significantly impacts children's height growth after bone marrow transplantation. Optimizing nutrition before the procedure can improve post-transplant height velocity in pediatric patients.
Area of Science:
- Pediatric Hematology/Oncology
- Pediatric Endocrinology
- Nutritional Science
Background:
- Bone marrow transplantation (BMT) is a critical treatment for various pediatric diseases.
- Growth impairment, particularly reduced height velocity, is a significant concern post-BMT.
- Pre-transplant factors influencing post-BMT outcomes require further investigation.
Purpose of the Study:
- To investigate the association between pre-transplant nutritional status and height velocity in children undergoing BMT.
- To identify specific nutritional markers that predict growth during the first year post-transplant.
Main Methods:
- Retrospective study of 37 children (1.4-12.4 years) undergoing BMT (allogeneic/autologous).
- Assessment of nutritional status included serum albumin, pre-albumin, transferrin, anthropometrics (weight, mid-arm circumference, triceps skinfold), and muscle index (MI) via ultrasound.
- Height velocity was measured as standard deviation score (SDS) during the first post-transplant year.
Main Results:
- The mean relative height velocity SDS was -1.6.
- Height velocity showed significant positive correlations with pre-transplant muscle index (r=0.54, P=0.004), mid-arm circumference (r=0.45, P=0.04), and serum transferrin concentration (r=0.33, P=0.05).
Conclusions:
- Pre-transplant nutritional status, particularly muscle mass and protein reserves, influences linear growth in children post-BMT.
- Optimizing nutritional status before BMT may be crucial for improving post-transplant growth outcomes.
Abstract:
We studied the influence of pre-transplant nutritional status on height velocity during the first post-transplant year. Thirty-seven children aged 1.4-12.4 years, 19 males and 18 females, underwent bone marrow transplantation (24 allogeneic, 13 autologous) with fractionated total body irradiation included in the preparative regimen of 25. The underlying diagnoses were leukemia (n = 16), malignant solid tumor (n = 11), and non-malignant hematologic or metabolic disease (n = 10). The serum concentrations of albumin, pre-albumin and transferrin were measured. Anthropometric measurements included weight, mid-arm circumference (MAC) and triceps skinfold thickness, expressed as percentages of the age- and sex-specific standards. The skeletal muscle protein reserve was estimated as muscle index (MI) by ultrasonographic imaging of the femoral quadriceps muscle. Height velocity was expressed as a standard deviation score (SDS) of the age- and sex-specific mean. The mean relative height velocity SDS was -1.6 (95% CI -2.2- -1.0). Height velocity correlated significantly with pre-transplant MI (r = 0.54, P = 0.004), concentration of serum transferrin (r = 0.33, P = 0.05) and MAC (r =0.45, P = 0.04). Our data suggest that pre-transplant nutritional status has an impact on growth in height during the post-transplant period.