The Prognostic Impact of Pretransplantation Inflammatory and Nutritional Status in Adult Patients after Myeloablative Single Cord Blood Transplantation

Biol Blood Marrow Transplant. 2019 May;25(5):981-988. doi: 10.1016/j.bbmt.2019.01.006. Epub 2019 Jan 11.

Abstract

Markers of inflammatory and nutritional status, such as the Controlling Nutritional Status (CONUT) score, Prognostic Nutritional Index, Glasgow Prognostic Score, and C-reactive protein-albumin ratio (CAR) has been demonstrated to be associated with poor prognosis in patients with various cancers. Although the relatively low cell dose of a single cord blood unit restricts the indication for cord blood transplantation (CBT) to pediatric and relatively smaller and lighter adult patients, the impact of malnutrition on outcomes after CBT is unclear. We retrospectively analyzed 165 adult patients who underwent myeloablative single-unit CBT in our institute. In multivariate analysis, a higher CONUT score, which is indicative of poor inflammatory and nutritional status, was significantly associated with poor outcomes, including low neutrophil engraftment and development of extensive chronic graft-versus-host disease. A higher CAR, which is also suggestive of poor inflammatory and nutritional status, was significantly associated with poor neutrophil engraftment and higher overall mortality. Body mass index (BMI) was not associated with transplantation outcomes. These data suggest that poor pretransplantation inflammatory and nutritional status might be a more practical parameter than lower BMI, for predicting transplantation outcomes after single CBT for adults.

Keywords: Body mass index; CRP-albumin ratio; Controlling nutritional status; Cord blood transplantation; Glasgow Prognostic Score; Prognostic nutritional index.

MeSH terms

  • Adult
  • Biomarkers / analysis
  • Body Mass Index
  • C-Reactive Protein / analysis
  • Cord Blood Stem Cell Transplantation / methods*
  • Cord Blood Stem Cell Transplantation / standards
  • Humans
  • Inflammation / diagnosis*
  • Myeloablative Agonists / therapeutic use
  • Neoplasms / diagnosis*
  • Neoplasms / therapy
  • Nutritional Status*
  • Prognosis
  • Retrospective Studies
  • Serum Albumin, Human / analysis
  • Young Adult

Substances

  • Biomarkers
  • Myeloablative Agonists
  • C-Reactive Protein
  • Serum Albumin, Human