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Changes in nutritional status, body composition, quality of life, and physical activity levels of cancer patients undergoing autologous peripheral blood stem cell transplantation

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Abstract

Purpose

This pilot exploratory study aimed to describe the changes in nutritional status, body composition, quality of life (QoL), and physical activity levels (PAL) of cancer patients undergoing high-dose conditioning and autologous peripheral blood stem cell transplantation (PBSCT) at pre-admission, hospital discharge, and at 100 days post-transplantation, and to examine if changes in these parameters are interrelated.

Methods

Twenty-four patients (56.2 ± 12.9 years; 7 females, 17 males) were recruited from an Australian transplant center. Assessment was prospectively conducted at pre-admission, hospital discharge, and 100 days post-transplantation using the scored patient-generated subjective global assessment, air displacement plethysmography, EORTC QLQ-C30 (version 3), and the international physical activity questionnaire.

Results

At discharge, nutritional status deteriorated (patient-generated subjective global assessment (PG-SGA) median, +8.0; interquartile range, 6.0–13.0; p < 0.001) and the number of malnourished patients increased (n = 8/23; p = 0.023). Patients experienced significant loss of lean body mass (LBM; −2.2 kg, CI 95 % −3.0, −1.4; p < 0.001), and decrease in QoL (−10.6, CI 95 % −24.1, 2.9; p = 0.117); the proportion of patients with high PAL decreased (p = 0.012). By 100 days post-transplantation, all patients were well-nourished; however, LBM remained lower −1.0 kg (CI 95 % −1.9, −0.1; p = 0.028). Change in nutritional status (PG-SGA score) was associated with weight (r = −0.46; p = 0.039) and fat mass (r = −0.57; p = 0.013). Change in QoL was associated with nutritional reservoir (i.e., fat; r = 0.54; p = 0.024); QoL was consistently higher for patients with high PAL.

Conclusions

High-dose conditioning and autologous PBSCT is associated with deterioration in nutritional status, QoL and PAL, with LBM remaining below baseline levels at 100 days post-transplantation. A nutrition and exercise intervention program post-hospital discharge may be beneficial for these patients.

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Abbreviations

APD:

accredited practicing dietitian

BEAM:

BCNU etoposide aracytine, melphalan

BMI:

body mass index

FM:

fat mass

HDC:

high-dose conditioning

HGS:

hand grip strength

IPAQ:

International Physical Activity Questionnaire

LBM:

lean body mass

PAL:

physical activity levels

PBSCT:

peripheral blood stem cell transplantation

PG-SGA:

patient-generated subjective global assessment

QoL:

quality of life

SGA:

subjective global assessment

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Acknowledgments

We thank The Wesley Research Institute for funding the study and the use of the body composition laboratory. We are grateful for the assistance of Catherine Kirk and the cooperation of participating patients.

Author information

Authors and Affiliations

  1. Centre for Dietetics Research, School of Human Movement Studies, The University of Queensland, Brisbane, 4072, Australia

    Yun-Chi Hung, Judith Bauer & Elisabeth Isenring

  2. The Wesley Hospital, Brisbane, 4066, Australia

    Judith Bauer & Pamela Horsley

  3. The Wesley Research Institute, Brisbane, 4066, QLD, Australia

    Mary Waterhouse

  4. Haematology & Oncology Clinics of Australia, The Wesley Hospital, Brisbane, 4066, Australia

    John Bashford

  5. Princess Alexandra Hospital, Queensland Health, Brisbane, 4102, Australia

    Elisabeth Isenring

Authors
  1. Yun-Chi Hung
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  2. Judith Bauer
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  3. Pamela Horsley
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  4. Mary Waterhouse
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  5. John Bashford
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  6. Elisabeth Isenring
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Corresponding author

Correspondence to Yun-Chi Hung.

Additional information

Abstract Note

This study was funded by the Wesley Research Institute. Results of this study were presented at the 2012 Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO), and the 2011 HAA Conference (Haematology Society of Australia and New Zealand (HSANZ), the Australian & New Zealand Society of Blood Transfusion (ANZSBT), and the Australasian Society of Thrombosis and Haemostasis (ASTH)).

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Hung, YC., Bauer, J., Horsley, P. et al. Changes in nutritional status, body composition, quality of life, and physical activity levels of cancer patients undergoing autologous peripheral blood stem cell transplantation. Support Care Cancer 21, 1579–1586 (2013). https://doi.org/10.1007/s00520-012-1698-y

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  • DOI: https://doi.org/10.1007/s00520-012-1698-y

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