Value of bioimpedance analysis and anthropometry for complication prediction in children with malignant and non-malignant diseases after hematopoietic stem cells transplantation

Hematopoietic stem cell transplantation (HSCT) is widely used in the treatment of malignant and autoimmune diseases. Various complications often develop during the post-transplantation period that can significantly impair the clinical outcomes, so the ability to predict the
risk of severe complications is of great practical importance. Predictive value of some anthropometric indices and bioimpedance analysis
(BIA) measured before conditioning to assess the risks of serious complications and graft hypofunction in the early post-transplant period
(100 days) were analyzed. Anthropometry and BIA used in a comprehensive assessment of nutritional status in order to optimize the nutritional support of these patients. 101 patients were examined before conditioning and at different times during the early post-transplant period: 50 children (5–17 years of age) were examined using BIA and anthropometry, 61 children (6 months – 4 years of age) – using only anthropometry without BIA due to age restrictions. The prognostic value of the phase angle (FA), ratio of the active cell mass to lean body mass (ACM/LBM) and shoulder muscle circumference (SMC) was shown. Thus, in patients with FA ≤ 4, ACM/LBM < 0.45 and SMC ≤ 10th percentile before conditioning risk of severe complications during early post-transplant period was significantly higher (p < 0.05). Also, in patients with FA ≤ 4 and ACM/LBM < 0.45 a significantly higher risk of graft hypofunction developing was observed (p < 0.05).

1. Вашура А.Ю., Коновалова М.В., Скоробогатова Е.В. и др. Нутритивный статус и тканевый состав тела у детей после трансплантации гемопоэтических стволовых клеток. Онкогематол 2011;4:33–8.

2. Forbes G.B. Human body composition: growth, aging, nutrition and activity. N.Y.: Springer, 1987. P. 350

3. Baumgartner R.N., Chumlea W.C., Roche A.F. et al. Bioelectric impedance phase angle and body composition. Amer J Clin Nutr 1988;48(1):16–23.

4. Николаев Д.В., Смирнов А.В., Бобринская И.Г., Руднев С.Г. Биоимпедансный анализ состава тела человека. М.: Наука, 2009. С. 391.

5. Коновалова М.В., Анисимова А.В., Вашура А.Ю. и др. Сравнительное биоимпедансное исследование состава тела детей с различными формами онкологических заболеваний в состоянии ремиссии. Онкогематол 2012;2:41–7.

6. Bosy-Westphal A., Danielzik S., Dorhofer R.-P. et al. Phase angle from bioelectrical impedance analysis: population reference values by age, sex, and body mass index. J Parenter Enteral Nutr 2006;30(4):309–16.

7. Selberg O., Selberg D. Norms and correlates of bioimpedance phase angle in healthy human subjects, hospitalized patients, and patients with liver cirrhosis. Eur J Appl Physiol 2002;86(6):509–16.

8. Gupta D., Lammersfeld C.A., Burrows J.L. et al. Bioelectrical impedance phase angle in clinical practice: implications for prognosis in advanced colorectal cancer. Am J Clin Nutr 2004;80(6):1634–8.

9. Gupta D., Lammersfeld C.A., Vashi P.G. et al. Bioelectrical impedance phase angle as a prognostic indicator in breast cancer. BMC Cancer 2008;8:249.

10. Santarpia L., Marra M., Montagnese C. et al. Prognostic significance of bioelectrical impedance phase angle in advanced cancer: preliminary observations. Nutrition 2009;25(9):930–1.

11. Cole T.J., Flegal K.M., Nicholls D., Jackson A.A. Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ 2007;335(7612):194.

12. Frisancho A.R. New norms of upper limb fat and muscle areas for assessment of nutritional status. Am J Clin Nutr 1981;34(11):2540–5.

13. Румянцев А.Г., Масчан А.А. Трансплантация гемопоэтических стволовых клеток у детей. М.: МИА, 2003. С. 912.

14. Schiavetti A., Fornari C. Bonci E. et al. Nutritional status in childhood malignancies. Nutr Cancer 2002;44:153–5.

15. Viana M.B., Murao M., Ramos G. et al. Malnutrition as a prognostic factor in lymphoblastic leukaemia: a multivariate analysis. Arch Dis Child 1994;71:304–10.

16. Lobato-Mendizabal E., Ruiz-Arguelles G.J., Marin-Lopez A. Leukemia and nutrition. I: Malnutrition is an adverse prognostic factor in the outcome of treatment of patients with standart-risk acute

17. lymphoblastic leukaemia. Leuk Res 1989;13:899–906.

18. Ottery F.D. Definition of standardized nutritional assessment and interventional pathways in oncology. Nutrition 1996; 12(1 Suppl):15–9.