Journal List > Korean J Nutr > v.43(1) > 1043820

Korean J Nutr. 2010 Feb;43(1):26-33. Korean.
Published online February 28, 2010.  https://doi.org/10.4163/kjn.2010.43.1.26
© 2010 The Korean Nutrition Society
Analysis of the Factors Relating Nutritional Status in Discharging of Leukemia Patients Receiving Chemotherapy
Eunjin So, Jeeyeon Kim, Sujin Jung and Sook Park
Nutrition Department of the Catholic University of Korea Seoul St. Mary's Hospital, Seoul 137-701, Korea.

To whom correspondence should be addressed. (Email: hiso@catholic.ac.kr )
Received January 04, 2010; Revised February 01, 2010; Accepted February 17, 2010.

Abstract

This study was performed to investigate the changes of oral diet intake during the admission period and identify the factors related with nutritional status in discharging of leukemia patients. This is a retrospective cross sectional study on 46 leukemia patients receiving chemotherapy at the Catholic University of Korea Seoul St. Mary's Hospital from July to September 2009. The patients' charts were surveyed on the general characteristics and factors relating chemotherapy. The calorie count method was used to investigate diet intake during admission period. Multivariate logistic regression analysis was used to identify possible confounding factors. A p < 0.05 was considered statistically significant. The mean age was 42.8 ± 14.6 years and the average length of stay was 30.4 ± 7.0 days. The incidence of malnourished patients was 60.9% in discharging. There was a significant difference in chemotherapy sessions and chemotherapy period between well-nourished and malnourished patients. The average energy intake was 1,525.9 kcal in well-nourished patients and 1,143 kcal in malnourished patients, which was significant different. From repeated measures ANOVA test, the changes of oral intake during admission period were significant by groups. In addition, there were significant differences in oral intake according to each period between well-nourished and malnourished patients. In multivariate logistic regression analysis, both the ratio of total oral energy intake to recommended energy intake and chemotherapy sessions were significantly associated with nutritional status in discharging. The results of this study could be used to establish a protocol of nutritional management for leukemia patients receiving chemotherapy.

Keywords: leukemia; chemotherapy; nutritional status; energy intake

Tables


Table 1
General characteristics of subjects (n = 46)
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Table 2
Oral intake status by the nutritional status in discharging
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Table 3
Change of oral intake during chemotherapy period by the nutritional status in discharging
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Table 4
Logistic regression model for variables affecting the nutritional status in discharging
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References
1. http://kosis.kr/domestic/theme/do01_index.jsp?listid=D&listn.
2. Ahn MJ. Stem cell transplantation in treatment of multiple myeloma. Korean J Med 2003;65(2):S539–S545.
3. Min WS. Bone marrow transplantation. Korean J Crit Care Med 2001;16(1):17–22.
4. Seong JM. In: Dr.Seong's leukemia clinic. Koonja Publishing Inc.; 2005.
5. Hoffbrand AV, Pettit JE, Moss PAH. In: Essential hematology. 4th edition. Panmun Books Co.; 2005.
6. Kim HM. Management of chemotherapy-related toxicity: Natrition support during chemotherapy. Korean Soc Clin Oncol 2005;4:23–33.
7. Chung HM, Lyckholm LJ, Smith TJ. Palliative care in BMT. Bone Marrow Transplant 2009;43:265–273.
8. Kim WG, Park MS, Lee YH, Heo DS. Nutritional risk in oncology outpatients receiving chemotherapy. Korean J Community Nutr 2008;13(4):573–581.
9. Yang YH, Lee DS. The relationship of anorexia, nausea, vomiting, oral intake and nutritional status in patients receiving chemotherapy. J Korean Acad Nurs 2000;30(3):720–730.
10. Yang YH, Kwon SJ, Kim CI. The nutritional status of the patients with cancer during the chemotherapies. J Korean Acad Nurs 2001;31(6):978–987.
11. Kim NC, Kim HS, Choi SE, Park HJ. Nutritional status of recipients of allogeneic hematopoietic stem cell transplantation by types of conditioning regimen. J Korea Community Health Nurs Acad Soc 2000;14(2):191–202.
12. Kim HJ, Noh MY, Jung NJ, Hong JI, Jung YS. A study of the factors affecting the term of engraftment during hematopoietic stem cell transplantation with a focus on the inhibitors of oral intake and the period of nutritional support. J Korean Diet Assoc 2009;15(2):168–178.
13. Penalva A, San Martin A, Rossello J, Perez-Portabella C, Palacios A, Julia A, Planas M. Oral nutritional supplementation in hematologic patients. Nutr Hosp 2009;24(1):10–16.
14. Schneider SM, Veyres P, Pivot X, Soummer AM, Jambou P, Filippi J, van Obberghen E, Hébuterne X. Malnutrition is an independent factor associated with nosocomial infection. Br J Nutr 2004;92:105–111.
15. Teresa F.. Amaral;Luis C.. Matos;Maria M.. Tavares;Ana Subtil;Rosario Martins;Margarida Nazare,Nuno sousa Pereira.The economic impact of disease-related malnutrition at hospital admission. Clin Nutr 2007;26:778–784.
16. Correia MI, Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of stay and costs evaluated through a multivariate model analysis. Clin Nutr 2003;22(3):235–239.
17. Choi K, Kim HJ, Cho HJ, Choe YG, Lee DY, Park SK, Koh YL, Oh SJ, Lee SS. Assessment of nutritional status and prognosis in advanced metastatic cancer. Korean J Med 2006;71(2):132–140.
18. Horsley P, Bauer J, Gallagher B. Poor nutrition status prior to peripheral blood stem cell transplantation is associated with increased length of hospital stay. Bone Marrow Transplant 2005;35:1113–1116.
19. Deeg HJ, Seidel K, Bruemmer B, Pepe MS, Appelbaum FR. Impact of patient weight on non-relapse mortality after marrow transplantation. Bone Marrow Transplant 1995;15(3):461–468.
20. Le Blanc K, Ringdén O, Remberger M. A low body mass index is correlated with poor survival after allogeneic stem cell transplantation. Haematologica 2003;88:1044–1052.
21. Mattsson J, Westin S, Edlund S, Remberger M. Poor oral nutrition after allogeneic stem cell transplantation correlates significantly with severe graft-versus-host disease. Bone Marrow Transplant 2006;38(9):629–633.
22. Norman K, Pichard C, Lochs H, Pirlich M. Prognostic impact of disease-related malnutrition. Clin Nutr 2008;27:5–15.
23. Hong JI, Chang UJ. The relationship between the period of engraftment and the nutritional status in patients undergoing allogenic bone marrow transplantation for acute myelogenous leukemia. Korean J Community Nutr 2002;7(4):578–584.
24. Iversen PO, Ukrainchenko E, Afanasyev B, Hulbekkmo K, Choukah A, Gulbrandsen N, Wisloff F, Tangen JM. Impaired nutritional status during intensive chemotherapy in Russian and Norwegian cohort with acute myeloid leukemia. Leuk Lymphoma 2008;49(10):1916–1924.
25. Manual of medical nutrition therapy. 3rd ed. The Korean Dietetic Association; 2008.
26. Bauer J, Capra S, Ferguson M. Use of the scored patient-generated subjective global assessment as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr 2002;56:779–785.
27. Isenring E, Bauer J, Capra S. The scored patient-generated subjective global assessment (PG-SGA) and its association with quality of life in ambulatory patients receiving radiotherapy. Eur J Clin Nutr 2003;57:305–309.
28. Hadjibabaie M, Iravani M, Taghizadeh M, Ataie-Jafari A, Shamshiri AR, Mousavi SA, Alimoghaddam K, Hosseini S, Ghavamzadeh A. Evaluation of nutritional status in patients undergoing hematopoietic SCT. Bone Marrow Transplant 2008;42:469–473.
29. Rzepecki P, Barzal J, Sarosiek T, Szczylik C. Biochemical indices for the assessment of nutritional status during hematopoietic stem cell transplantation: are they worth using? A single center experience. Bone Marrow Transplant 2007;40:567–572.
30. Kristine L. Funk,Celeste M. Ayton.Improving malnutrition documentation enhances reimbursement. J Am Diet Assoc 1995;95:468–475.
31. Eriksson KM, Cederholm T, Palmblad JE. Nutrition and Acute Leukemia in Adults. Cancer 1998;82(6):1071–1077.
32. Ulrich E.. Schaible,Stefan H. Kaufmann.Malnutrition and infection: complex mechanism and global impacts. PLoS Med 2007;4(5):e115.
33. Bow EJ, Meddings JB. Intestinal mucosal dysfunction and infection during remission-induction therapy for acute myeloid leukemia. Leukemia 2006;20:2087–2092.
34. Jaime-Pérez JC, González-Llano O, Herrera-Garza JL, Gutiérrez-Aguirre H, Vázquez-Garza E, Gómez-Almaguer D. Assessment of nutritional status in children with acute lymphoblastic leukemia in Northern Mexico: A 5-year experience. Pediatr Blood Cancer 2008;50:506–508.
35. Iversen PO, Wisløff F, Gulbrandsen N. Reduced nutritional status among multiple myeloma patients during treatment with high-dose chemotherapy and autologous stem cell support. Clin Nutr 2009;29:1–4.
36. Iversen PO, Ukrainchenko E, Afanasyev B, Hulbekkmo K, Choukah A, Gulbrandsen N, Wisløff F, Tangen JM. Impaired nutritional status during intensive chemotherapy in Russian and Norwegian cohorts with acute myeloid leukemia. Leuk Lymp 2008;49(10):1916–1924.
37. Muscaritoli M, Grieco G, Capria S, Iori AP, Rossi Fanelli F. Nutritional and metabolic support in patients undergoing bone marrow transplantation. Am J Clin Nutr 2002;75:183–190.