(OR03-03-23) Nutrition Risk and Physical Function of Patients With Acute Myeloid Leukemia or Myelodysplastic Syndrome Before Allogeneic Hematopoietic Cell Transplantation

Objectives: The purpose of this secondary data analysis was to identify the prevalence of nutritional risk and poor physical function among patients admitted for inpatient allogeneic hematopoietic cell transplantation.

Methods: Electronic medical record charts were reviewed for 153 adult patients who underwent allogeneic hematopoietic cell transplantation (allo-HCT) between 2014 and 2019. The nutrition risk index (NRI) and time to complete five sit-to-stand (5STS) repetitions were used to classify nutritional risk and functional status at time of allo-HCT admission. Patients at high nutrition risk had an NRI score < 97.5, and patients with poor physical function took > 11.19 seconds to complete 5STS or required bilateral upper arm support. Patients were then classified as having a high-risk classification in one, both, or neither variables. Classification results were aggregated as frequencies and percentages. R was used to conduct descriptive statistics.

Results: Patients were (58.5 ± 12.5) years old, 85 (56%) male sex, and 123 (80%) white race. Disease distribution was 100 patients (65%) with acute myeloid leukemia (AML) and 53 patients (35%) with myelodysplastic syndrome (MDS). Patients were admitted with a body mass index of (27.6 kg/m² ± 5.5) and a pre-HCT 90-day weight loss of (0.7% ± 5.4). The NRI classified 37 patients (24%) with moderate or worse nutrition risk, and the 5-repetition sit-to-stand classified 125 patients (82%) with poor physical function. In patients with complete data, 30 (20%) were high-risk in both categories.

Conclusions: High nutritional risk and poor physical function are both prevalent conditions prior to allo-HCT. Individuals with high-risk status in the pre-HCT period may be more likely to experience regimen-related toxicities and have a greater risk for transplant-related mortality. Thus, pre-habilitation with nutrition and physical function interventions in patients classified as high risk may have the potential to improve post-transplant clinical outcomes, treatment tolerance, and quality of life.

Funding Sources: This research was supported in part by project grants from the National Cancer Institute of the National Institutes of Health.