Korean Journal of Community Nutrition (대한지역사회영양학회지)

The Korean Society of Community Nutrition (대한지역사회영양학회)
권호 표지

The Relationship between the Period of Engraftment and the Nutritional Status in Patients Undergoing Allogenic Bone Marrow Transplantation for Acute Myelogenous Leukemia

동종 골수이식을 받은 급성 골수성 백혈병 환자의 영양상태와 생착일수에 관한 연구

  • 홍정임 (가톨릭대학교 성모병원 영양과) ;
  • 장은재 (동덕여자대학교 자연과학대학 식품영양학과)
  • Published : 2002.08.01
Download PDF
⟨ Previous Next ⟩

Abstract

This study was designed to investigate the association between the period of engraftment and the nutritional status of patient s undergoing bone marrow transplantation for acute myelogenous leukemia (AML). Nutritional status was evaluated by body mass index (BMI), percentage of ideal body weight (PIBW), percentage of weight loss, and serum albumin, total protein (T protein), hemoglobin (HGB) and hematocrit (HCT) levels on the day prior to transplantation and on the day of bone marrow transplantation. The periods of engraftment were determined by absolute neutrophil counts (ANC) above $500/mm^3$ from the day of bone marrow transplantation. The study subjects were 80 patients (55 males, 25 females) with acute myelogenous leukemia admitted to the University Hospital in Seoul. The result of this study is as follows : Tie nutritional status values of the majority of patients on the day prior to transplantation were in the normal range except for HGB and HCT ; however, during hospitalization, all of the levels of the nutritional status values were significantly decreased. The periods of engraftment of the abnormal group according to their BMI, PIBW, HGB and HCT levels on the day of bone marrow transplantation showed no difference when compared to the normal group. However, the periods of engraftment of the abnormal group, according to the percentage of weight loss, albumin, and T protein levels were significantly decreased when compared to the normal group. Therefore, the nutritional status of patients at the time of transplant had a noticeable influence on the periods of engraftment. Our results suggested that nutritional status is a critical factor of engraftment in BMT during pre-transplant and post-transplant. Futhermore, we recommend that the process of nutritional preparation for the transplant should initiate immediately after the transplant decision has been made.

Keywords

References

  1. 가톨릭대학교 성모병원 간호부(1995) : 1995 년도 혈액종양 빛 골수이식환자 간호관리, p.173-183
  2. 김동집(1998) : 혈액종양 질환 및 골수이식의 개요, 혈액종양 및 골수이식환자 간호관리, 가톨릭대학 성모병원 간호부, pp.1 -4
  3. 김영혜(1995) :서울중앙병원 임상영양핸드북, 아산재단 서울중앙병원 영양팀, pp.17-28
  4. 김학기(1997) 소아 골수이식 1997년도 혈액종양 및 골수이식환자 간호관리, 가톨릭대학교 성모병원 간호부, pp.151-159
  5. 대한영양사회(1994) : 임상영양지침서, pp.11-27
  6. Anasetti C, Appelbaum FR, Bjerke JW, Bruemmer B, Clift R, Gooley T, Hansen JA. Morton AJ, Martin PJ, Petersdorf EW, Sanders JE, Storb R, Sullivan KM, Woolfrey A (1998): Association between pretransplant interferon-alpha and outcome after unrelated donor marrow transplantation for chronic myelogenous leukemia in chronic phase. Blood 92 (2): 394-401
  7. Andersen JW, Bennett JM, Cassileth PA, Paietta E, Tallman MS, Rowe JM, Young ML, Wiernik PH (1997): Long-term survival in acute myeloid leukemia: the Eastern Cooperative Oncology Group experience. Cancer 80(11 Suppl): 2205-2209
  8. Apperley JF, Cohen A, Duell T, Kolb HJ, Ljungman P, Rovelli A, Socie G, Tichelli A, Van Lint MT, Weiss M (1999): Nutritional status and growth after bone marrow transplantation (BMT) during childhood: EBMT Late-Effects Working Party retrospective data. European Group for Blood and Marrow Transplantation. Bone Marrow Transplantation 23 (10): 1043-1047
  9. Barrett AJ, Young NS (1995): The treatment of severe acquired aplastic anemia. Blood 85: 3367-3377
  10. Bourge R, Costanzo MR, Grady KL, Jaski B, Kirklin J, Naftel D, Pitts D, Rayburn B, VanBakei A, White-Williams C (1999): Are preoperative obesity and cachexia risk factors for post heart transplant morbidity and mortality: a multi-institutional study of preoperative weight-height indices. Cardiac Transplant Research Database (CTRD) Group. Journal of Heart & Lung Transplantation 18 (8): 750-763
  11. Buchholz AC, Goodwin RA, McKim MK, O'Connor DL, Stuart B (1999): Caregiving arrangement and nutrition: good news with some reservations. Canadian Journal of Public Health. Revue Canadienne de Sante Publique 90(1): 45-51
  12. Chan YC, Suzuki M, Yamamoto S (1997): Nutritional status of centenarians assessed by activity and anthropometric, hematological and biochemical characteristics. J Nutr Sci Vitaminol (Tokyo) 43 (1): 73-81
  13. Choi JY, Shin WS, Yoo JH, Kim YL, Kang MW, Kim HK, Kim WI (1993): Changing Trend of Infection After Allogeneic Bone Marrow Transplantation - Comparison Between 1983-1988 and 1989-1992. J Korean Society for Chemotherapy 11: 132-139
  14. Cunningham BA, Lenssen P, Aker SA, Gittere KM, Cheney CL, Hutchison MA (1983): Nutritional Considerations During Marrow Transplantation. Nurs Clin North Am 18 (3): 585-596
  15. Dey B, Sergio JJ, Sykes M, Yang YG (1997): Interleukin-12 prevents severe acute graft-versus - host disease (GVHD) and GVHD-associated immune dysfunction in a fully major histocompatibility complex haplotype-mismatched murine bone marrow transplantation model. Transplantation 64 (9): 1343-1352 https://doi.org/10.1097/00007890-199711150-00018
  16. Eriksson KM, Cederholm T, Palmblad JE (1998): Nutrition and Acute Leukemia in Adults: relation between nutritional status and infectious complications during remission induction. Cancer 82 (6): 1071-1077
  17. Eugene CA (1997): Nutrition and survival after bone marrow transplant. The American Society of Hematology (ASH) Meeting, pp.5-9, Conrad Group, Inc. December
  18. Fibbe WE, Kromhout D, Lestra JA, Romijn JA, Zwinderman AH (1999): Parenteral nutrition following intensive cytotoxic therapy: an exploratory study on the need for parenteral nutrition after various treatment approaches for haematological malignancies. Bone Marrow Transplantation 23 (9): 933-939
  19. Gibson RS (1990): Principles of nutritional assessment, pp.351-359, Oxford University Press
  20. Gibson BE, McColl JH, Weir J, Reilly JJ (1999): Prevalence of protein-energy malnutrition at diagnosis in children with acute lymphoblastic leukemia. Journal of Pediatric Gastroenterology & Nutrition 29(2): 194-197
  21. G mez Candela C, de Cos Blanco AI, Martfnez Olmos MA, Hern ndez MJ Rodriguez A, Ojeda E, Garcia Bustos J (1997): Soporte nutricional en transplante de m dula sea. Nutr Hosp 12(5): 263-269
  22. Grant A (1979): Nutritional assessment guidelines, Northgate Station Seattle, 2nd, pp.36-45
  23. Grant JP (1992): Handbook of Total Parenteral Nutrition, pp.337-338, W.B. Sounders Company
  24. Jeanne WM (1996): Nutritional Assessment and Its Application. J IV Nurs 19(6): 307-314
  25. Kenneth KJ, Stephen MG, Edward ST, Gina AB, Joseph ZD (1999): The Effects of Nutritional Status on Outcome After Hip Fracture. J Orthop trauma 13(3): 164-169
  26. Kristy HM, Christopher D, Linda G, Alexandra CC, Denise RS, Sharon CB, William S, Clifford L (1995): Malnutrition in Hospitalized Pediatric Patients - Current Prevalence -. Arch Pediatr Adoles Med 149(10): 1118-1122
  27. Lee KH, Lee JH, Lee JS, Kim SH, Kim WK, Kim CC, Lee JW, Kim BK, Park SY, Lee HG, Yoon SS, Kim HC, Nam DK, Hahn JS, Min YH, Hyun MS, Hwang TJ, Chung U, Park YS, Lee JA (1998): Allogeneic bone marrow transplantation for chronic myelocytic leukemia: retrospective analysis of Korean experience. J of the Korean Society of Hematopoietic Stem Cell Transplantation 3 (2): 143-151
  28. Lee KH, Lee JH, Lee JS, Seo CW, Kim SH, Kim SB, Kim JK (1997): Frequency and Clinical Pattern of Graft-Versus-Host Disease after Allogeneic Bone Marrow Transplantation - A -Single Institution Experience. Journal of the Korean Society of Hematopoietic Stem Cell Transplantation 2 (1): 51-62
  29. Lee KH, Lee JW, Kim S, Lee JS, Kim SH, Kim WK (1999): Allogeneic Bone Marrow Transplantation in Adult Acute Myelocytic Leukemia-Experience in a Single Institution. J of the Korean Society of Hematopoietic Stem Cell Transplantation 4 (1): 49-57
  30. Lin G, Wang J, Wang X (1997): [244 patients with hyperleukocytic acute leukemia. Shanghai Leukemia Cooperation Group]. Chung-Hua Nei Ko Tsa Chih Chinese. Journal of Internal Medicine 36(8): 532-535
  31. Muscaritoli M, Conversano L, Torelli GF, Arcese W, Capria S, Cangiano C Falcone C, Fanelli FR (1998): Clinical and metabolic effects of different parenteral nutrition regimens in patients undergoing allogeneic bone marrow transplantation. Transplantation 66(5): 610-620
  32. Niederwieser D, Pepe M, Storb R, Loughran TP, Longton G (1998): Improvement in rejection, engraftment rate and survival without increase in graft-versus-host disease by high marrow cell dose in patients transplanted for aplastic anemia. Br J Haematol 69: 23-28
  33. O'Brien S, Kantarjian HM, Keating M, Gagnon G, Cork A, Trujillo J, McCredie KB (1989): Association of granulocytosis with poor prognosis in patients with acute myelogenous leukemia and translocation of chromosomes 8 and 21. J Clin Oncol 7 (8): 1081-1086
  34. Preisler H (1993): Poor prognosis acute myelogenous leukemia. Leuk Lymphoma 9(4-5): 273-283
  35. Song SU, Kim JN, Lim HS (1998): A study on the status of nutrition support in bone marrow transplantation patients. J Korean Diet Assoc 4(1): 65-75
  36. Taskinen M, Saarinen UM (1996): Skeletal muscle protein reserve after bone marrow transplantation in children. Bone Marrow Transplant 18: 937-941
  37. Wang X, Lin G, Wang J (1997): [244 patients with hyperleukocytic acute leukemia. Shanghai Leukemia Cooperation Group]. Chin J Intern Med 36(8): 532-535
  38. Weisdorf SA, Lysne VJ, Wind D, Haake RJ, Sharp HL, Goldman A, Schissel K, McGlave PB, Ramsay NK, Kersey JH (1987): Positive effect of prophylatic total parenteral nutrition on long-term outcome of bone marrow transplantation. Transplantation 43: 833-838