移植前骨骼肌质量对异基因造血干细胞移植早期结果影响的队列研究

Background??Allogeneic hematopoietic stem cell transplantationallo-HSCT is an effective treatment for hematopoietic malignancies. Malnutrition is a common complication and negatively affects prognosis. Muscle mass has been shown to reflect the nutritional status of patients earlier than blood biochemical parameters such as albumin. Howeverthe influence of pre-transplantation muscle mass on the complications associated with early transplantation remains unclear. Objective ?To investigate the effect of pre-transplant skeletal muscle mass on the early outcomes of allo-HSCTprovide a clinical basis for nutritional interventions and prognosis improvement. Methods ?A prospective cohort study was conducted with 77 leukemia patients who underwent allo-HSCT at the Medical Center of HematologyXinqiao Hospital in Chongqing from January to October 2022. Bioelectrical impedance analysis was used to assess skeletal muscle mass. The patients were divided into the normal skeletal muscle massnormal SMM group of 36 cases and low skeletal muscle masslow SMM group of 41 cases according to their skeletal muscle mass. Baseline dataincluding personal and clinical detailswere collected. Early post-transplant complications within 30 days post-transplant such as oral mucositisgastrointestinal symptomsinfection and hematopoietic reconstitution time between the two groups were compared using SPSS 23.0 software. Results??There was no statistically significant difference in the incidence of diarrheanauseavomitingand abdominal pain/gastritis incidence between the normal and low SMM groupsP>0.05. The incidence of oral mucositishypoalbuminemiaovert gastrointestinal bleedingand infection was lower in the normal SMM group than in the low SMM groupP<0.05. The severity of oral mucositis in patients in the normal SMM group was lower than that in the low SMM groupP<0.001. Neutrophil implantation time and platelet implantation time were longer in patients in the low SMM group than in the normal SMM groupP<0.01. Conclusion??The pre-transplant patients had a high incidence of low skeletal muscle mass. The low skeletal muscle mass before transplantation correlates with the occurrence of oral mucositishypoalbuminemiaovert gastrointestinal bleedingand infectionsas well as extended neutrophil and platelet engraftment time in the early transplantation periodand patients should be screened as early as possible prior to transplantation to boost skeletal muscle mass and improve early post-transplant outcomes.