Comparison of pre- and posttransplant energy expenditure in patients undergoing hematopoietic stem cell transplantation and evaluation of associated factors

Izabella Barbosa Vieira; Nayara Salgado Vieira Sette; Cristiane Alves de Oliveira; Maria Isabel Toulson Davisson Correia; Camila Kummel Duarte; Simone Vasconcelos Generoso

doi:10.1016/j.nut.2023.112260

Comparison of pre- and posttransplant energy expenditure in patients undergoing hematopoietic stem cell transplantation and evaluation of associated factors

Nutrition. 2024 Feb:118:112260. doi: 10.1016/j.nut.2023.112260. Epub 2023 Oct 9.

Authors

Izabella Barbosa Vieira¹, Nayara Salgado Vieira Sette², Cristiane Alves de Oliveira³, Maria Isabel Toulson Davisson Correia⁴, Camila Kummel Duarte¹, Simone Vasconcelos Generoso⁵

Affiliations

¹ Nutrition and Health Program, Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
² Food Sciences, Department of Food, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
³ Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
⁴ Department of Surgery, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
⁵ Nutrition and Health Program, Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Electronic address: simonenutufmg@gmail.com.

PMID: 37980778
DOI: 10.1016/j.nut.2023.112260

Abstract

Objectives: Patients undergoing hematopoietic stem cell transplantation may present with metabolic alterations that can have an effect on their energy expenditure and nutritional status. This project aimed to compare the pre- and posttransplant energy expenditures of patients undergoing hematopoietic stem cell transplantation as well as related factors.

Methods: This prospective study was conducted at a single center. Patients, undergoing autograft or allograft, were evaluated before transplantation and on the 10th and 17th d posttransplantation. Energy expenditure was measured by indirect calorimetry. Diet intake was assessed by a 24-h dietary recall. Infectious and noninfectious complications were analyzed between days 1 to 10 after transplantation and days 11 to 17 after transplantation. Paired model analyses were carried out to identify the pretransplantation and posttransplantation periods.

Results: Twenty patients were evaluated with a mean age of 45.6 ± 17.2 y; a majority were male sex (65%), and the most frequent diagnoses were chronic myeloid leukemia (25%) and multiple myeloma (25%). Energy expenditure increased by 15% posttransplantation, and the energy requirement per kilogram of weight was 23 kcal/kg at day 10 after transplantation. Throughout the posttransplantation period, 45% of the patients required nutritional therapy. Negative energy and negative protein balance were observed at all analyzed times. Phase angle (P = 0.018), fever (P = 0.014), mucositis grades I to II (P = 0.018), and the total number of infectious and noninfectious events (P = 0.043) were associated with an increase in energy expenditure at day 10 after transplantation.

Conclusions: Energy expenditure increased after transplantation compared with pretransplantation in 50% of patients. Phase angle, fever, grades I to II mucositis, and infectious and noninfectious events were associated with increased energy expenditure at day 10 after transplantation.

Keywords: Clinical outcomes; Energy expenditure; Hematological diseases; Hematopoietic stem cell transplantation; Nutrition status.

MeSH terms

Adult
Calorimetry, Indirect
Energy Metabolism
Female
Hematopoietic Stem Cell Transplantation* / adverse effects
Humans
Male
Middle Aged
Mucositis*
Nutritional Status
Prospective Studies