Body Composition, Nutritional Status, and Dietary Intake in the First 100 Days After Stem Cell Transplantation and Their Link to One-Year Mortality in Leukemia Patients

Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative treatment for acute leukemia; however, the first year after transplantation is associated with an increased risk of morbidity and mortality. This study aimed to evaluate changes in nutritional intake and body composition during the first 100 days following allo-HSCT and to examine their associations with one-year all-cause mortality. In this single-center prospective study, 152 adults scheduled to undergo allo-HSCT were assessed at baseline and on days +30 and +100 after transplantation. Assessments included anthropometric and body-composition measurements, dietary intake evaluation, and nutritional risk screening using the Nutritional Risk Screening 2002 (NRS-2002) tool. The prevalence of nutritional risk increased from 8.6% at baseline to 69.1% on day +30. In the primary analysis, a greater decline in fat-free mass (FFM) was associated with an increased risk of death within one year after transplantation (adjusted HR = 1.04 per 1-kg loss). However, this association was no longer observed in the landmark sensitivity analysis. During the first 100 days following allo-HSCT, nutritional status and body composition deteriorated markedly. A greater decline in FFM was associated with higher one-year mortality in the primary analysis; however, this association was attenuated and was no longer statistically significant in the landmark sensitivity analysis.