- Click here for explanation of classification scheme.

Identify the prevalence of the nutrition-related problems and to provide descriptive data about the nutritional status of long-term survivors of allogeneic marrow transplants.

Patients who received allogeneic transplant between January 1982 and July 1984 and who were alive and disease-free one year after transplant.

• Refusal or financial inability to return to FHCRC for follow-up visit (23 patients)
• Evaluation at home (three patients)
• Medical inability to return because of leukoencephalopathy induced by cumulative chemoradiotherapy treatment (one patient)
• Chart unavailable for review (eight patients)
• Incomplete nutrition data (four patients)
• Retrun to FHCRC more than 15 months after transplant (two patients)
• A total of 192 were reviewed out of 223.

• Recruitment: Not clear. I think they were asked when they came back after one year. I did not see anything about IRB or signed consent. Much of the data was pulled as a retrospective chart review.
• Design: Descriptive, retrospective chart review of patients from start date to an end date and those that came back after one year.

Timing of Measurements

Some data pulled from chart before transplant and then pulled from chart one year after the transplant.

Dependent Variables

• Variable One: Upper-arm anthropometrics or arm muscle area (no description given)
• Variable Two: Arm fat area 
• Variable Three: Body weight and ideal body weight (balance scale in light clothing)
• Variable Four: Vitamin and mineral supplement, weight changes, taste alterations, oral sensitivity, vomiting, gastric reflux, dysphagia, abnormal stool output (interview by RD)
• Variable Five: Diet history by RD
• Variable Six: Food frequency questionnaire
• Variable Seven: Nutritionally relevant labs (potassium, magnesium, glu, renal and liver function).

Independent Variables

Chronic GVHD status: None, limited, extensive.

Control Variables

• Diagnosis
• Sex
• Age
• Drug treatment
• Karnofsky scores.

• Initial N: 223
• Attrition (final N): 192 with all accounted for
• Age: 65 under 18 years; 127 over 18 years of age
• Ethnicity: Not given

Other Relevant Demographics

• Aplastic anemia: 28
• Acute lymphoblastic leukemia: 31
• Acute non-lymphoblastic leukema: 57
• Chronic myelogenous leukemia: 61
• Other: 15.

Location

Seattle, WA.

 

 

Variables	Treatment Group Measures and Confidence Intervals	Control Group Measures and Confidence Intervals	Statistical Significance of Group Difference
Dependent Variable One One year only <25th percentile	None = 59% Limited = 46% Extensive = 60%		None done
Dependent Variable Two >75th percentile	None = 28% Limited = 37% Extensive = 47%
Dependent Variable Three <90% IBW	None = 13% Limited = 11% Extensive = 24%
Dependent Variable Four One year only oral sensitivity	None = 7% Limited = 14% Extensive = 41%
Dependent Variable Four Xerostomia	None = 10% Limited = 11% Extensive = 27%
Dependent Variable Five >115% of kcal need	None = 40% Limited = 50% Extensive = 30%
Dependent Variable Six FFQ protein >115% of protein need	None = 48% Limited = 45% Extensive = 48%
Dependent Variable Six Gamma glutamyl transferase	None = 11% Limited = 12% Extensive = 44%

Other Findings

 

Weight change and oral sensitivity were comon problems.

• High prevalence of nutrition problems among recipients of allogeneic marrow transplantation one year after transplant
• Suggests need for ongoing community-based nutrition monitoring after discharge from a transplant center.

Government:

National Cancer Institute, NHLBI

• The authors comment on the bias in that only people who returned after one year were included in the analysis and we don't know why the others did not return. It appears from the percentage provided that the Extensive Group had more of these problems, but we also do not know what kind of care people did receive when they went home. Maybe those with non- or limited chronic GVHD did receive some kind of nutritional care and that is why their chronic GVHD was not extensive.
• Very hard to make conclusions from this data
• I struggled between a neutral or a minus on the quality. I did end up with a neutral, but maybe it should be a minus.