Changes in body composition in children with acute graft-versus-host disease within the first 100 days after hematopoietic stem cell transplantation

• Published in: European journal of clinical nutrition 2018-08, Vol.72 (8), p.1167-1175
• Main Authors: Feng, Yi, Pan, Li-ya, Shen, Li-yuan, Chang, Pan-pan, Zhang, Bing-hua, Hong, Li
• Format: Article
• Language: English
• Subjects: 692/699/1702; 692/700/1720; Acute Disease; Adipose Tissue; Adolescent; Anthropometry; Arm; Body composition; Body Composition - physiology; Body fat; Body Mass Index; Body size; Child; Child health; Child, Preschool; Children; Clinical Nutrition; Complications and side effects; Critically ill children; Epidemiology; Fat-free body mass; Female; Glucocorticoids; Graft versus host disease; Graft vs Host Disease - physiopathology; Graft-versus-host reaction; Hematopoietic stem cell transplantation; Hematopoietic Stem Cell Transplantation - adverse effects; Hematopoietic stem cells; Humans; Internal Medicine; Longitudinal Studies; Male; Medical examination; Medical schools; Medicine; Medicine & Public Health; Metabolic Diseases; Mucositis; Muscles; Pediatrics; Physical growth; Physiological aspects; Physiological research; Prospective Studies; Public Health; Stem cell transplantation; Stem cells; Steroids (Organic compounds); Transplantation
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/s41430-017-0057-y

Background Acute graft-versus-host-disease (aGVHD) is one of the main complications of hematopoietic stem cell transplantation (HSCT). This study investigated the changes in body composition of pediatric patients with aGVHD during the first 100 days after HSCT. Methods Fifty-five children receiving HSCT were divided into two groups (aGVHD and non-aGVHD). Body mass index Z -scores (BMI- z ), arm muscle area index (AMAI), fat mass index (FMI), and fat-free mass index (FFMI) were measured on the day of transplantation (H0), and on the 30th (H30), 60th (H60), and 100th day (H100) after the transplantation. The correlative factors on body composition were evaluated. Results In the aGVHD group, the rates of absolute change of BMI- z at H30, H60, and H100 showed a significant increase as compared to that at H0, especially at H30 which was remarkably higher than that of the non-aGVHD group ( P =  0.008). AMAI showed a continuous decrease from H0 to H100 in the aGVHD group; also FFMI was found to be lower than that of the non-aGVHD group during the first 100 days after transplantation, however, no significant differences were found between the two groups. At H60 and H100, FFMI in the aGVHD group was lower than that in the non-aGVHD group ( P  = 0.014, P   =  0.032, respectively). Glucocorticoid treatment and the occurrence of mucositis were the key factors for changes in body composition in the aGVHD group. Conclusions Changes in body composition are characterized by a lean reduction in body mass and increase in adipose tissues in the early stage of post-transplantation in the aGVHD children. Glucocorticoid treatment and occurrence of mucositis are the two important factors that were found to affect body composition after HSCT.