Reduced nutritional status among multiple myeloma patients during treatment with high-dose chemotherapy and autologous stem cell support

Clin Nutr. 2010 Aug;29(4):488-91. doi: 10.1016/j.clnu.2009.12.002. Epub 2009 Dec 30.

Abstract

Background & aims: Multiple myeloma (MM) ranks among the most frequent blood cancers in adults. Optimal treatment consists of high-dose chemotherapy and autologous stem cell transplantation. Health-related quality of life (HRQoL) is reduced before, during, and after therapy. Several HRQoL items are associated with nutritional health, e.g., nausea/vomiting, appetite loss and fatigue. It is unknown whether nutritional status in MM is affected by treatment. Hence we assessed nutritional status before, during and (1/2) year after treatment-start.

Methods: We applied anthropometry (height, weight, hand-grip strength, triceps skinfold) and plasma concentrations of biomarkers to assess nutritional status. HRQoL was determined with the EORTC QLQ-C30 questionnaire.

Results: The anthropometrical parameters all decreased (p<0.05) during treatment, but were restored at the end of the observation period. Albumin and the fat-soluble vitamins D and E followed a similar pattern, whereas transferrin and vitamin A were unchanged (p>0.05). Interestingly, markers of thyroid function declined and remained low (p<0.05) even 6 months after start of therapy. Nutrition-associated symptoms used as markers of HRQoL worsened during therapy, but returned to pre-therapy levels.

Conclusion: Intensive therapy in MM is associated with a decline in both nutritional status and health-related quality of life.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anthropometry
  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers / blood
  • Body Size
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple Myeloma / blood
  • Multiple Myeloma / drug therapy*
  • Multiple Myeloma / physiopathology
  • Multiple Myeloma / therapy*
  • Nutritional Status / drug effects*
  • Quality of Life / psychology
  • Stem Cell Transplantation* / adverse effects
  • Surveys and Questionnaires
  • Time Factors
  • Transplantation, Autologous

Substances

  • Antineoplastic Agents
  • Biomarkers