The impact of pretransplant malnutrition on allogeneic hematopoietic stem cell transplantation outcomes
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Citações na Scopus
17
Tipo de produção
article
Data de publicação
2019
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER
Autores
HIROSE, Erika Yuri
MOLLA, Vinicius Campos de
GONCALVES, Matheus Vescovi
PEREIRA, Andre Domingues
SZOR, Roberta Shcolnik
FONSECA, Ana Rita Brito Medeiro da
FATOBENE, Giancarlo
SERPA, Mariana Gomes
XAVIER, Erick Menezes
TUCUNDUVA, Luciana
Citação
CLINICAL NUTRITION ESPEN, v.33, p.213-219, 2019
Resumo
Background: Malnutrition is a common finding in allogeneic hematopoietic stem cell transplantation (alloHSCT) patients, and there is some evidence that malnutrition might negatively affect the transplant outcomes. Method: We performed a retrospective study with 148 patients aged 18-75 years, who underwent alloHSCT between 2011 and 2017. Patients were classified according to the body mass index (BMI) and the Subjective Global Assessment (SGA). The SGA was assessed on the day of hospitalization for the transplant, and classifies patients into three groups: A (well-nourished), B (moderately malnourished) and C (severely malnourished). Results: The SGA classified 49 (33%) patients as well-nourished, 54 (37%) as moderately malnourished, and 45 (30%) as severely malnourished. SGA-C was also associated with severe acute graft versus host disease (aGVHD) with a cumulative incidence (CI) of 31% vs. a CI of 14% for combined well-nourished or moderately malnourished group (SGA-A or -B, P = 0.017). In multivariate analysis, SGA-C compared to SGA-A or -B, remained as an independent risk factor for aGVHD (hazard ratio - HR 1.68, 95% confidence interval - 95% CI 1.02-2.74), and nonrelapse mortality (NRM - HR 3.63, 95% CI 1.76-7.46), worse progression free survival (HR 2.12, 95% CI 1.25-3.60), and worse overall survival (HR 3.27, 95% CI 1.90-5.64). Conclusion: Malnutrition increases the risk of aGVHD and NRM and has a negative impact on survival.
Palavras-chave
Malnutrition, Subjective global assessment, Graft-versus-host disease, Allogeneic hematopoietic stem cell transplantation, Survival
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