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Tytuł pozycji:

Nutritional status as a predictor of adverse events and survival in pediatric autologous stem cell transplant.

Tytuł :
Nutritional status as a predictor of adverse events and survival in pediatric autologous stem cell transplant.
Autorzy :
Kranjčec I; Department of Oncology and Hematology, Children's Hospital Zagreb, Zagreb, Croatia.
Matijašić N; Department of Pediatrics, Children's Hospital Zagreb, Zagreb, Croatia.
Mašić M; Department of Pediatrics, Children's Hospital Zagreb, Zagreb, Croatia.
Švigir A; Department of Pediatrics, Children's Hospital Zagreb, Zagreb, Croatia.
Jakovljević G; Department of Oncology and Hematology, Children's Hospital Zagreb, Zagreb, Croatia.; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.
Bolanča A; Department of Oncology and Nuclear Medicine, University Hospital Center Sestre milosrdnice, Zagreb, Croatia.; School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
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Źródło :
Pediatric hematology and oncology [Pediatr Hematol Oncol] 2020 Nov; Vol. 37 (8), pp. 717-731. Date of Electronic Publication: 2020 Jul 25.
Typ publikacji :
Journal Article
Język :
English
Imprint Name(s) :
Publication: 2006- : London : Informa Healthcare
Original Publication: Washington, DC : Hemisphere Pub. Corp., c1986-
MeSH Terms :
Nutritional Status*
Hypophosphatemia/*complications
Mucositis/*complications
Neoplasms/*therapy
Stem Cell Transplantation/*adverse effects
Transplantation, Autologous/*adverse effects
Adolescent ; Body Mass Index ; Body Weight ; Child ; Child, Preschool ; Croatia ; Female ; Humans ; Hypokalemia/complications ; Infant ; Infant, Newborn ; Male ; Mucositis/physiopathology ; Neoplasms/blood ; Neoplasms/mortality ; Neuroblastoma/blood ; Neuroblastoma/mortality ; Neuroblastoma/therapy ; Obesity/complications ; Recurrence ; Retrospective Studies ; Risk Factors ; Serum Albumin/metabolism ; Stem Cell Transplantation/mortality ; Transplantation, Autologous/mortality ; Treatment Outcome ; Young Adult
Contributed Indexing :
Keywords: Autologous transplantation; children; nutritional status; survival; toxicity
Substance Nomenclature :
0 (Serum Albumin)
Entry Date(s) :
Date Created: 20200728 Date Completed: 20210216 Latest Revision: 20210216
Update Code :
20210218
DOI :
10.1080/08880018.2020.1797254
PMID :
32715852
Czasopismo naukowe
Nutritional status is recognized as an independent and modifiable risk factor of outcome in stem cell transplant. Our research aim was to evaluate the impact of body mass index (BMI) and serum albumin on the prevalence of adverse events and survival in autologous transplant in children. A retrospective study was conducted of autologous transplants performed between 2006 and 2017 in the Children's Hospital Zagreb, Croatia. Nutritional status was assessed at the times of diagnosis, procedure, and discharge using BMI (underweight, normal, obese) and serum albumin (grades 1-4). Adverse events (fever, gastrointestinal toxicity, electrolyte disturbances, dysglycemia) and outcome (3-year, relapse, mortality) were documented. Seventy-seven children (54.5% males, mean age 7.9 years) underwent autologous transplant, mostly for neuroblastoma. In terms of BMI and albumin, which showed significant positive correlation at diagnosis ( p  = 0.026) and transplant ( p  = 0.016), most participants were well nourished. Average post-transplant weight loss was 4%. Major toxicities were severe mucositis (72.7%) and hypophosphatemia (31.2%). Relapse and mortality rates were 35.1% and 42.9%, respectively. Hypokalemia ( p  = 0.041) and hypomagnesemia ( p  = 0.044) were more prevalent in the underweight group, while obese children experienced significantly less severe mucositis ( p  = 0.016) and hypophosphatemia ( p  = 0.038). There was no significant difference regarding outcome among children of different nutritional status, although undernourished children tended to have lower relapse and mortality rates. In conclusion, underweight children are significantly more prone to severe electrolyte disorders and mucositis, and although statistical significance was not reached, are more likely to survive.

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