Changes in body composition in children with acute graft-versus-host disease within the first 100 days after hematopoietic stem cell transplantation

Abstract

Background

Acute graft-versus-host-disease (aGVHD) is one of the main complications of hematopoietic stem cell transplantation (HSCT). This study investigated the changes in body composition of pediatric patients with aGVHD during the first 100 days after HSCT.

Methods

Fifty-five children receiving HSCT were divided into two groups (aGVHD and non-aGVHD). Body mass index Z-scores (BMI-z), arm muscle area index (AMAI), fat mass index (FMI), and fat-free mass index (FFMI) were measured on the day of transplantation (H0), and on the 30th (H30), 60th (H60), and 100th day (H100) after the transplantation. The correlative factors on body composition were evaluated.

Results

In the aGVHD group, the rates of absolute change of BMI-z at H30, H60, and H100 showed a significant increase as compared to that at H0, especially at H30 which was remarkably higher than that of the non-aGVHD group (P = 0.008). AMAI showed a continuous decrease from H0 to H100 in the aGVHD group; also FFMI was found to be lower than that of the non-aGVHD group during the first 100 days after transplantation, however, no significant differences were found between the two groups. At H60 and H100, FFMI in the aGVHD group was lower than that in the non-aGVHD group (P = 0.014, P= 0.032, respectively). Glucocorticoid treatment and the occurrence of mucositis were the key factors for changes in body composition in the aGVHD group.

Conclusions

Changes in body composition are characterized by a lean reduction in body mass and increase in adipose tissues in the early stage of post-transplantation in the aGVHD children. Glucocorticoid treatment and occurrence of mucositis are the two important factors that were found to affect body composition after HSCT.

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Acknowledgements

We thank Chen-lin Zhu for extraction of the data and the staff of hematology and oncology Department for their kind cooperation. We also thank Statistician (Shi-jian Liu) for data analysis.

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Correspondence to Li Hong.

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Feng, Y., Pan, Ly., Shen, Ly. et al. Changes in body composition in children with acute graft-versus-host disease within the first 100 days after hematopoietic stem cell transplantation. Eur J Clin Nutr 72, 1167–1175 (2018). https://doi.org/10.1038/s41430-017-0057-y

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