Ability of individual patient health parameters to predict malnutrition among elderly stem cell transplant patients.

Abstract

e21521 Background: Increasing number of geriatric patients are now being considered as suitable candidates for allogeneic hematopoietic cell transplantation (HCT). Malnutrition being a common comorbidity in older cancer patients with no gold standard in malnutrition screening tools, it warrants for a better understanding of the health of geriatric cancer patients from a nutrition stand point. This study was pursued to evaluate individual patient parameters to predict malnutrition among elderly stem cell transplant patients. Methods: A retrospective cohort analysis was conducted on patients eligible for allogeneic HCT at the MD Anderson Cancer Center. Nutrition was assessed using the Mini Nutritional Assessment tool. Individual parameters to predict malnutrition included body mass index of less than 24 and weight loss of more than 3 kgs in the past 3 months. Statistical analysis was conducted using SPSS, version 23. Results: Mean age of the study participants was 65 years. Majority of the study population had the diagnosis of acute myelogenous leukemia (AML) at the time evaluation. The mean BMI of the study participants was 28.91 +- 4.77 while the mean MNA score was 24.95 +- 3.39. There was no association found between patient characteristics and history of weight loss or abnormal BMI. There was a significant association (p < 0.001) found between loss of more than 3 kg weight and an abnormal MNA score. There was no association found between any of the patient characteristics and abnormal BMI with abnormal MNA. The sensitivity of weight loss in comparison with MNA score was 62.5% and the specificity was 91%, thus, having a positive and negative predictive value of 77% and 84% respectively. Given that 86% of our patients were either overweight or obese at the time of evaluation, from those who were under weight, 100% had an abnormal MNA and 50% of normal weight patients had an abnormal MNA. Conclusions: The significant association between weight loss and poor MNA status shows that we are moving in the right direction to provide answers to nutrition status using individual patient health parameters.