Increase in height during the first year after bone marrow transplantation reflecting nutritional status of children.

Abstract

We studied the influence of pre-transplant nutritional status on height velocity during the first post-transplant year. Thirty-seven children aged 1.4-12.4 years, 19 males and 18 females, underwent bone marrow transplantation (24 allogeneic, 13 autologous) with fractionated total body irradiation included in the preparative regimen of 25. The underlying diagnoses were leukemia (n = 16), malignant solid tumor (n = 11), and non-malignant hematologic or metabolic disease (n = 10). The serum concentrations of albumin, pre-albumin and transferrin were measured. Anthropometric measurements included weight, mid-arm circumference (MAC) and triceps skinfold thickness, expressed as percentages of the age- and sex-specific standards. The skeletal muscle protein reserve was estimated as muscle index (MI) by ultrasonographic imaging of the femoral quadriceps muscle. Height velocity was expressed as a standard deviation score (SDS) of the age- and sex-specific mean. The mean relative height velocity SDS was -1.6 (95% CI -2.2- -1.0). Height velocity correlated significantly with pre-transplant MI (r = 0.54, P = 0.004), concentration of serum transferrin (r = 0.33, P = 0.05) and MAC (r =0.45, P = 0.04). Our data suggest that pre-transplant nutritional status has an impact on growth in height during the post-transplant period.