Muscle loss persists in leukaemia patients despite medical nutrition therapy

Muscle or fat-free mass (FFM) decreases in patients with acute myeloid leukaemia (AML) or myelodysplastic syndrome (MDS) undergoing intensive chemotherapy despite medical nutrition therapy (MNT), reports a recent study. Fat mass, on the other hand, remains unchanged.

A total of 126 newly diagnosed AML/MDS patients who received intensive remission-induction chemotherapy, routine dietary counselling by a dietician, and MNT immediately upon inadequate nutritional intake were included in this multicentre, prospective, observational study.

The researchers assessed nutritional status, including Patient-Generated Subjective Global Assessment (PG-SGA)-scores and body composition, physical outcomes, and fatigue at treatment initiation and discharge. They also examined the association of nutritional status/body composition with physical outcomes, fatigues, fever duration, number of complications, time to neutrophil engraftment, and hospital length of stay (LOS) using multiple regression analysis.

Nutritional intake was adequate in >91 percent of AML/MDS patients, with 61 percent receiving MNT. However, body weight still significantly decreased (p<0.001) due to loss of muscle/FFM (p<0.001), but fat mass did not change (p-value range=0.71‒0.77).

Body weight and waist circumference were negatively associated with fever duration and number of complications. Mid-upper arm muscle circumference (MUAMC) was positively associated with physical functioning, as was PG-SGA-scores with fatigue. In addition, body weight and MUAMC also showed negative associations with LOS.

“Maintenance of nutritional status was associated with improved physical and clinical outcomes,” the researchers said.