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Nutritional status and energy expenditure in children pre-bone-marrow-transplant

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The aims of this study were to establish the nutritional status of children pre-BMT and to determine whether predictive methods of assessing nutritional status and resting energy expenditure (REE) are accurate in this population. We analysed the body cell mass (BCM) (n=26) and REE (n=24) in children undergoing BMT. BCM was adjusted for height (BCM/HTp) and expressed as a Z score to represent nutritional status. To determine whether body mass index (BMI) was indicative of nutritional status in children undergoing BMT, BMI Z scores were compared to the reference method of BCM/HTp Z scores. Schofield predictive equations of basal metabolic rate (BMR) were compared to measured REE to evaluate the accuracy of the predictive equations. The mean BCM/HTp Z score for the subject population was −1.09±1.28. There was no significant relationship between BCM/HTp Z score and BMI Z score (r=0.34; P>0.05); however there was minimal difference between measured REE and predicted BMR (bias=−11±149 kcal/day). The results of this study demonstrate that children undergoing BMT may have suboptimal nutritional status and that BMI is not an accurate indication of nutritional status in this population. However, Schofield equations were found to be suitable for representing REE in children pre-BMT.

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References

  1. Langdana A, Tully N, Molloy E et al. Intensive enteral nutrition support in paediatric bone marrow transplantation. Bone Marrow Transplant 2001; 27: 741–746.

    Article  CAS  PubMed  Google Scholar 

  2. Schulte C, Reinhardt W, Beelen D et al. Low T3-syndrome and nutritional status as prognostic factors in patients undergoing bone marrow transplantation. Bone Marrow Transplant 1998; 22: 1171–1178.

    Article  CAS  PubMed  Google Scholar 

  3. Masszi T . Supportive care. In: Apperley J, Carreras E, Gluckman A, Gratwohl A, Masszi T (eds). The European Group for Blood and Marrow Transplantation: Haemopoietic Stem Cell Transplantation. Forum Service Editore: Italy, 2004, pp 119–131.

    Google Scholar 

  4. Muscaritoli M, Grieco G, Capria S et al. Nutritional and metabolic support in patients undergoing bone marrow transplantation. Am J Clin Nutr 2002; 75: 183–190.

    Article  CAS  PubMed  Google Scholar 

  5. Papadopoulou A . Nutritional considerations in children undergoing bone marrow transplantation. Eur J Clin Nutr 1998; 52: 863–871.

    Article  CAS  PubMed  Google Scholar 

  6. Muscaritoli M, Conversano L, Cangiano C et al. Biochemical indices may not accurately reflect changes in nutritional status after allogeneic bone marrow transplantation. Nutrition 1995; 11: 433–436.

    CAS  PubMed  Google Scholar 

  7. Cohen A, Duell T, Socie G et al. 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 Transplant 1999; 23: 1043–1047.

    Article  CAS  PubMed  Google Scholar 

  8. Hopman GD, Pena EG, Le Cessie S et al. Tube feeding and bone marrow transplantation. Med Pediatr Oncol 2003; 40: 375–379.

    Article  CAS  PubMed  Google Scholar 

  9. Schofield W . Predicting basal metabolic rate: New standards and review of previous work. Hum Nutr Clin Nutr 1985; 39 (Suppl. 1): 5–41.

    PubMed  Google Scholar 

  10. White MS, Shepherd RW, McEniery JA . Energy expenditure in 100 ventilated, critically ill children: improving the accuracy of predictive equations. Crit Care Med 2000; 28: 2301–2312.

    Article  Google Scholar 

  11. Cole TJ, Freeman JV, Preece MA . Body mass index reference curves for the UK, 1990. Arch Dis Child 1995; 73: 25–29.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Moore FD . Energy and the maintenance of the body cell mass. J Parenter Enteral Nutr 1980; 4: 228–260.

    Article  CAS  Google Scholar 

  13. Wang Z, St Onge MP, Lecumberii B et al. Body cell mass: model development and validation at the cellular level of body composition. Am J Physiol Endocrinol Metab 2004; 286: E123–E128.

    Article  CAS  PubMed  Google Scholar 

  14. Bland JM, Altman DG . Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307–310.

    Article  CAS  PubMed  Google Scholar 

  15. Cheney CL, Abson KG, Aker SN et al. Body composition changes in marrow transplant recipients receiving total parenteral nutrition. Cancer 1987; 59: 1515–1519.

    Article  CAS  PubMed  Google Scholar 

  16. Szeluga DJ, Stuart RK, Brookmeyer R et al. Nutritional support of bone marrow transplant recipients: a prospective, randomized clinical trial comparing total parenteral nutrition to an enteral feeding program. Cancer Res 1987; 47: 3309–3316.

    CAS  PubMed  Google Scholar 

  17. Pietsch JB, Ford C . Children with cancer: measurements of nutritional status at diagnosis. Nutr Clin Pract 2000; 15: 185–188.

    Article  Google Scholar 

  18. Talluri A, Liedtke R, Mohamed EI et al. The application of body cell mass index for studying muscle mass changes in health and disease conditions. Acta Diabetol 2003; 40 (Suppl. 1): S286–S289.

    Article  PubMed  Google Scholar 

  19. Ringwald-Smith K, Heslop HE, Krance RA et al. Energy expenditure in children undergoing hematopoietic stem cell transplantation. Bone Marrow Transplant 2002; 30: 125–130.

    Article  CAS  PubMed  Google Scholar 

  20. Seashore JH . Nutritional support of children in the intensive care unit. Yale J Biol Med 1984; 57: 111–134.

    CAS  PubMed  PubMed Central  Google Scholar 

  21. Harris JA, Benedict FG . A Biometric Study of Basal Metabolism in Man. Carnegie Institute: Washington, DC, 1919.

    Google Scholar 

  22. World Health Organization. Energy and Protein Requirements: Report of a Joint FAO/WHO/UNO Expert Consultation. World Health Organization: Geneva, 1985.

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White, M., Murphy, A., Hastings, Y. et al. Nutritional status and energy expenditure in children pre-bone-marrow-transplant. Bone Marrow Transplant 35, 775–779 (2005). https://doi.org/10.1038/sj.bmt.1704891

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