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Abnormal body composition related to the early clinical adverse outcome after HSCT

Bone Marrow Transplantation volume 57, pages 1191–1193 (2022)Cite this article

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Despite the recent advances in preventative and therapeutic techniques, transplantation-related complications, such as acute graft-versus-host disease (aGVHD) and infectious diseases, continue to be widespread and life-threatening [1]. The treatment of established aGVHD and infection is still a huge challenge. More targeted preventive measures must be developed to reduce the risk of aGVHD and infection. Nutritional status is a possible prognostic factor for allogeneic hematopoietic stem cell transplantation (allo-HSCT) outcome. Conventional methods use weight and body mass index (BMI) to indicate nutritional status. However, conflicting findings are obtained regarding the impact of weight or BMI on transplantation outcomes [2, 3]. Conflicts in findings may occur because weight does not distinguish abnormalities in body composition, such as fat free mass (FFM) and fat mass (FM). Our study examined the trajectory of change in the body composition across the HSCT period and explored body composition alterations and early post-transplantation complications to determine the extent to which abnormalities in body composition may predict early HSCT outcomes.

Between October 2018 and December 2020, 190 adult patients were enrolled at the First Affiliated Hospital of Soochow University in our study. All patients received conditioning regimens with modified malylan, busulphan/cyclophosphamide and anti-human thymosin globulin. Allografts were mobilized peripheral-blood stem cells or bone marrow cells from HLA-identical related or unrelated donors. The study period started before conditioning and continued until 100 days after transplantation. The data on early clinical outcomes after HSCT (within 100 days after haematopoietic stem cell reinfusion), including gastrointestinal mucositis, infection (hemorrhagic cystitis (HC), cytomegalovirus (CMV), Epstein–Barr virus (EBV) and active pulmonary infection), aGVHD, disease recurrence and mortality, were collected. Body composition was monitored by bioelectrical impedance analysis on baseline(1 day before the use of conditioning treatment), pre-transplantation (1 day before transplantation) and post-transplantation (14 days after transplantation, which was approximately the time of hematopoietic reconstruction). Body composition related indicators were defined refer to previous literature [4, 5].

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Fig. 1: Longitudinal changes in body composition from baseline to 14 days post-transplantation.

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This work was supported by grants from the National Natural Science Foundation of China (Grant Nos. 81803216, 81970138), Suzhou Young Key Health Talents “National Tutor System” project, Translational Research Grant of NCRCH (Grant No. 2020ZKMB05), Jiangsu Province “333” project, Social Development Project of the Science and Technology Department of Jiangsu (Grant No. BE2021649) and Gusu Key Medical Talent Program (Grant No. GSWS2019007).

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Author notes

  1. These authors contributed equally: Li-Ling Zong, Xiang Zhang, Shan-Shan Jiang.

Authors and Affiliations

  1. Department of Clinical Nutrition, The First Affiliated Hospital of Soochow University, Suzhou, China

    Li-Ling Zong & Jing Yang

  2. National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China

    Xiang Zhang, Bo Hu, Yong-Qin Ge, Xia-Ming Zhu & Sheng-Li Xue

  3. Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China

    Xiang Zhang, Bo Hu, Yong-Qin Ge, Xia-Ming Zhu & Sheng-Li Xue

  4. Department of Hematology, Soochow Hopes Hematonosis Hospital, Medical Group of the First Affiliated Hospital of Soochow University, Suzhou, China

    Shan-Shan Jiang

Authors
  1. Li-Ling Zong
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Contributions

JY and SLX designed the study, the writing of the study protocol. SSJ, XZ, YQG and LLZ performed research and analyzed the data; XMZ guided the experiment. LLZ wrote the original manuscript. BH checked the language. JY and SLX reviewed and edited the manuscript. All authors have read and agreed to the published version of the manuscript.

Corresponding authors

Correspondence to Sheng-Li Xue or Jing Yang.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

This study protocol was approved by the Ethics Committee review board of the First Affiliated Hospital of Soochow University and registered at ClinicalTrials.gov, ID NCT04146870.

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Zong, LL., Zhang, X., Jiang, SS. et al. Abnormal body composition related to the early clinical adverse outcome after HSCT. Bone Marrow Transplant 57, 1191–1193 (2022). https://doi.org/10.1038/s41409-022-01687-6

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