Nutritional and Body Composition Changes in Paediatric β-Thalassemia Patients Undergoing Hematopoietic Stem Cell Transplantation: A Retrospective Study Using Bioelectrical Impedance Analysis

Luyang Zhang; Li Wang; Jiewen Long; Yan Yin; Sandip Patil

doi:10.2147/JMDH.S463796

Nutritional and Body Composition Changes in Paediatric β-Thalassemia Patients Undergoing Hematopoietic Stem Cell Transplantation: A Retrospective Study Using Bioelectrical Impedance Analysis

J Multidiscip Healthc. 2024 May 9:17:2203-2214. doi: 10.2147/JMDH.S463796. eCollection 2024.

Authors

Luyang Zhang^#¹, Li Wang^#², Jiewen Long¹, Yan Yin¹, Sandip Patil¹

Affiliations

¹ Department of Haematology and Oncology, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, 518000, People's Republic of China.
² Department of Clinical Nutrition, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, 518000, People's Republic of China.

^# Contributed equally.

Abstract

Objective: This retrospective study evaluated nutritional status and body composition changes in paediatric β-thalassemia (β-TM) patients before and after hematopoietic stem cell transplantation (HSCT), using bioelectrical impedance analysis (BIA), and explored their relationship with HSCT outcomes.

Methods: A cohort of 40 paediatric β-TM patients undergoing allogeneic HSCT was assessed for their nutritional status, anthropometric parameters, including body mass index (BMI), weight, and height, and body composition parameters pre-and post-HSCT, focusing on BIA measurements, including intracellular water (ICW), extracellular water (ECW), fat mass (FAT), fat-free mass (FFM), Skeletal Muscle Mass (SMM), soft Lean Mass (SLM), percent body fat (PBF), Body Cell Mass (BCM), Phase angle (PA) and muscle balance pre- and post-HSCT. Post-HSCT clinical outcomes, including acute graft-vs-host disease (aGVHD), engraftment time, oral mucositis (OM), sinusoidal obstruction syndrome (SOS), and diarrhoea in relation to nutrition status after HSCT were analysed.

Results: After HSCT, 28.21% experienced diminished nutritional status, with 71.43% of those who were wasting before HSCT showing diminished nutritional status, significantly higher than the normal group (18.75%, P = 0.012). Anthropometric changes included significant weight reduction (87.5%, 22.15 ± 7.46 vs 20.74 ± 6.57, P < 0.001) and BMI decrease (90%, 15.19 ± 1.70 vs 14.05 ± 1.48, P < 0.001). Body composition parameters, which are FFM, SMM, SLM, ICW, ECW, BCM, and PA (18.26 ± 5.71 vs 17.27 ± 5.19, 8.68 ± 3.30 vs 7.93 ± 3.02, 17.11 ± 5.28 vs 16.06 ± 4.84, 8.19 ± 2.54 vs 7.62 ± 2.31, 5.15 ± 1.58 vs 4.94 ± 1.47, 11.74 ± 3.63 vs 10.92 ± 3.32, 4.42 ± 0.50 vs 3.90 ± 0.57, respectively, P < 0.001) analysis revealed significant decreases. No significant differences in clinical outcomes were observed based on nutritional status.

Conclusion: Paediatric β-TM patients undergoing HSCT exhibit significant changes in nutrition status and body composition, emphasizing the need for focused attention on malnourished children who are more prone to diminished nutritional status. Comprehensive BIA aids in understanding the impact, urging consideration for extended follow-up and larger cohorts in future research.

Keywords: BIA; HSCT; bioelectrical impedance analysis; hematopoietic stem cell transplantation; malnourished children; nutritional status; paediatric β-thalassemia.

Grants and funding

This work was supported by funding from Sanming Project of Medicine in Shenzhen SZSM202211033; Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties (SZGSP012); Shenzhen Key Medical Discipline Construction Fund (SZXK034); Guangdong High-level Hospital Construction Fund; Shenzhen High-level Hospital Construction Fund; and Shenzhen Science and Technology Program (SGDX20201103095404018).