Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Correspondence
  • Published:

Malnutrition risk prior to hematopoietic stem cell transplantation predicts mortality in adults


Patients with hematological malignancies have a high risk of developing malnutrition. Few data are currently available that illustrate the impact of the patients’ nutritional status prior to HSCT on their outcome. The aim of this study was to investigate the association between the patients’ malnutrition status prior to receiving autologous or allogeneic HSCT and mortality in adults with hematological malignancies. We conducted a retrospective cohort study including 341 patients. Survival curves and Cox proportional-hazards models were used to reveal whether malnutrition risk served as a predictor for the overall mortality and non-relapse mortality. The survival curves revealed that patients with malnutrition risk prior to HSCT had an increased risk of death during the 1-year follow-up period (overall mortality as well as non-relapse mortality). This result was confirmed by the Cox regression models, which showed a mortality risk that is more than two times higher in patients at risk of malnutrition. In allogeneic transplant patients, the impact of malnutrition risk on mortality was even higher. Our conclusions presuppose that nutrition is an important factor during the holistic treatment of HSCT patients by all healthcare professionals involved in the care of this patient group. Future studies should be carried out to examine how and whether different nutritional interventions effectively improve the nutritional status of this patient group.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Association of malnutrition risk at the time of hospital admission and mortality in patients undergoing HSCT.


  1. Yilmaz M, Atilla FD, Sahin F, Saydam G. The effect of malnutrition on mortality in hospitalized patients with hematologic malignancy. Supportive Care Cancer: Off J Multinatl Assoc Supportive Care Cancer. 2020;28:1441–8.

    Article  Google Scholar 

  2. Arends J, Baracos V, Bertz H, Bozzetti F, Calder PC, Deutz NEP, et al. ESPEN expert group recommendations for action against cancer-related malnutrition. Clin Nutr. 2017;36:1187–96.

    Article  CAS  PubMed  Google Scholar 

  3. Cederholm T, Jensen GL, Correia M, Gonzalez MC, Fukushima R, Higashiguchi T, et al. GLIM criteria for the diagnosis of malnutrition—a consensus report from the global clinical nutrition community. Clin Nutr. 2019;38:1–9.

    Article  CAS  PubMed  Google Scholar 

  4. Ryan AM, Power DG, Daly L, Cushen SJ, Ni Bhuachalla E, Prado CM. Cancer-associated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later. Proc Nutr Soc. 2016;75:199–211.

    Article  PubMed  Google Scholar 

  5. Eglseer D, Seymann C, Lohrmann C, Hoedl M. Nutritional problems and their non-pharmacological treatment in adults undergoing haematopoietic stem cell transplantation—a systematic review. Eur J Cancer Care. 2020;29:e13298.

    Article  Google Scholar 

  6. Baumgartner A, Zueger N, Bargetzi A, Medinger M, Passweg JR, Stanga Z, et al. Association of nutritional parameters with clinical outcomes in patients with acute myeloid leukemia undergoing haematopoietic stem cell transplantation. Ann Nutr Metab. 2016;69:89–98.

    Article  CAS  PubMed  Google Scholar 

  7. Urbain P, Birlinger J, Ihorst G, Biesalski HK, Finke J, Bertz H. Body mass index and bioelectrical impedance phase angle as potentially modifiable nutritional markers are independent risk factors for outcome in allogeneic hematopoietic cell transplantation. Ann Hematol. 2013;92:111–9.

    Article  PubMed  Google Scholar 

  8. Roller RE, Eglseer D, Eisenberger A, Wirnsberger GH. The Graz Malnutrition Screening (GMS): a new hospital screening tool for malnutrition. Br J Nutr. 2016;115:650–7.

    Article  CAS  PubMed  Google Scholar 

  9. August DA, Huhmann MB. A.S.P.E.N. clinical guidelines: nutrition support therapy during adult anticancer treatment and in hematopoietic cell transplantation. JPEN J Parenter Enter Nutr. 2009;33:472–500.

    Article  Google Scholar 

  10. Cederholm T, Barazzoni R, Austin P, Ballmer P, Biolo G, Bischoff SC, et al. ESPEN guidelines on definitions and terminology of clinical nutrition. Clin Nutr. 2017;36:49–64.

    Article  CAS  PubMed  Google Scholar 

  11. van der Linden SJ, Harinck MEG, Speksnijder HT, Schroder T, Schlosser I, Verkerk V, et al. Supportive care. In: Kenyon M, Babic A, editors. The European blood and marrow transplantation textbook for nurses: under the auspices of EBMT. Cham: Springer; 2018. p. 197–219.

  12. Baumgartner A, Bargetzi M, Bargetzi A, Zueger N, Medinger M, Passweg J, et al. Nutritional support practices in hematopoietic stem cell transplantation centers: a nationwide comparison. Nutrition. 2017;35:43–50.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Doris Eglseer.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Eglseer, D., Bauer, S., Huber-Kraßnitzer, B. et al. Malnutrition risk prior to hematopoietic stem cell transplantation predicts mortality in adults. Bone Marrow Transplant 56, 2268–2271 (2021).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:

This article is cited by


Quick links