PMID- 36079847
OWN - NLM
STAT- MEDLINE
DCOM- 20220912
LR  - 20220913
IS  - 2072-6643 (Electronic)
IS  - 2072-6643 (Linking)
VI  - 14
IP  - 17
DP  - 2022 Aug 31
TI  - Malnutrition Prevention after Allogeneic Hematopoietic Stem Cell Transplantation 
      (alloHSCT): A Prospective Explorative Interventional Study with an Oral Polymeric 
      Formulation Enriched with Transforming Growth Factor Beta 2 (TGF-beta2).
LID - 10.3390/nu14173589 [doi]
LID - 3589
AB  - Malnutrition is common after allogeneic Hematopoietic Stem Cell Transplantation 
      (alloHSCT), and interventions directed to correct nutritional status are 
      warranted to improve transplant outcomes. In this prospective study, an oral 
      polymeric formulation enriched with TGF-beta2 (TE-OPF) was explored to correct 
      malnutrition according to Patient-Generated Subjective Global Assessment 
      (PG-SGA). TE-OPF was proposed to 51 consecutive patients who received transplants 
      at our institution for hematological malignancies, and sufficient dose intake was 
      established per protocol as at least 50% of the prescribed dose of TE-OPF: group 
      A received adequate nutritional support; group B, inadequate. The study met the 
      primary outcomes in terms of safety (no adverse events reported during TE-OPF 
      intake except for its disgusting taste) and malnutrition (PG-SGA C 28 days after 
      transplant): severely malnourished patients (PG-SGA C) accounted for 13% in group 
      A and 88.9% in group B (p = 0.000). At the end of the study, after a median 
      follow-up of 416 days, the estimated median Overall Survival (OS) was 734 days 
      for well or moderately nourished patients (PG-SGA A/B) in comparison to 424 for 
      malnourished patients (p = 0.03). Inadequate TE-OPF intake was associated with an 
      increase in acute gastrointestinal Graft Versus Host Disease (GVHD) cumulative 
      incidence (38% vs. 0% p = 0.006). A higher incidence of pneumonia was reported in 
      group B (p = 0.006). IGF-1 levels at 14 and 28 days after transplant were 
      significantly higher in group A and were associated with a lower incidence of 
      acute GVHD (aGVHD). Higher subsets of B, T, and NK cells were found in group A, 
      and a higher number of CD16+ NK cells was associated with a lower incidence of 
      acute GVHD (p = 0.005) and increased survival at the end of the study (p = 
      0.023). Artificial neural network analysis suggested that inadequate TE-OPF 
      intake, pneumonia, and sepsis significantly affected malnutrition 28 days after 
      alloHSCT and survival 365 days after alloHSCT (normalized importance 100%, 82%, 
      and 68%, respectively). In this exploratory and preliminary study, the use of 
      TE-OPF appeared to reduce the incidence of malnutrition after alloHSCT, but 
      larger and controlled studies are required.
FAU - Morello, Enrico
AU  - Morello E
AUID- ORCID: 0000-0003-0406-6579
AD  - Department of Clinical and Experimental Sciences, University of Brescia, Bone 
      Marrow Transplant Unit, ASST-Spedali Civili di Brescia, 25123 Brescia, Italy.
FAU - Arena, Francesco
AU  - Arena F
AD  - Department of Clinical and Experimental Sciences, University of Brescia, Bone 
      Marrow Transplant Unit, ASST-Spedali Civili di Brescia, 25123 Brescia, Italy.
FAU - Malagola, Michele
AU  - Malagola M
AD  - Department of Clinical and Experimental Sciences, University of Brescia, Bone 
      Marrow Transplant Unit, ASST-Spedali Civili di Brescia, 25123 Brescia, Italy.
FAU - Farina, Mirko
AU  - Farina M
AUID- ORCID: 0000-0002-2980-9028
AD  - Department of Clinical and Experimental Sciences, University of Brescia, Bone 
      Marrow Transplant Unit, ASST-Spedali Civili di Brescia, 25123 Brescia, Italy.
FAU - Polverelli, Nicola
AU  - Polverelli N
AUID- ORCID: 0000-0001-6297-9697
AD  - Department of Clinical and Experimental Sciences, University of Brescia, Bone 
      Marrow Transplant Unit, ASST-Spedali Civili di Brescia, 25123 Brescia, Italy.
FAU - Cavagna, Elsa
AU  - Cavagna E
AD  - Department of Clinical and Experimental Sciences, University of Brescia, Bone 
      Marrow Transplant Unit, ASST-Spedali Civili di Brescia, 25123 Brescia, Italy.
FAU - Colnaghi, Federica
AU  - Colnaghi F
AD  - Department of Clinical and Experimental Sciences, University of Brescia, Bone 
      Marrow Transplant Unit, ASST-Spedali Civili di Brescia, 25123 Brescia, Italy.
FAU - Donna, Lorenzo
AU  - Donna L
AD  - Department of Clinical and Experimental Sciences, University of Brescia, Bone 
      Marrow Transplant Unit, ASST-Spedali Civili di Brescia, 25123 Brescia, Italy.
FAU - Zollner, Tatiana
AU  - Zollner T
AD  - Department of Clinical and Experimental Sciences, University of Brescia, Bone 
      Marrow Transplant Unit, ASST-Spedali Civili di Brescia, 25123 Brescia, Italy.
FAU - Accorsi Buttini, Eugenia
AU  - Accorsi Buttini E
AD  - Department of Clinical and Experimental Sciences, University of Brescia, Bone 
      Marrow Transplant Unit, ASST-Spedali Civili di Brescia, 25123 Brescia, Italy.
FAU - Andreoli, Marco
AU  - Andreoli M
AD  - Dietetics and Clinical Nutrition Unit, ASST-Spedali Civili Brescia, 25123 
      Brescia, Italy.
FAU - Ricci, Chiara
AU  - Ricci C
AUID- ORCID: 0000-0002-0748-6600
AD  - Gastroenterology Unit, ASST-Spedali Civili Brescia-University of Brescia, 25123 
      Brescia, Italy.
FAU - Leoni, Alessandro
AU  - Leoni A
AD  - Department of Clinical and Experimental Sciences, University of Brescia, Bone 
      Marrow Transplant Unit, ASST-Spedali Civili di Brescia, 25123 Brescia, Italy.
FAU - Samarani, Emanuela
AU  - Samarani E
AD  - Department of Clinical and Experimental Sciences, University of Brescia, Bone 
      Marrow Transplant Unit, ASST-Spedali Civili di Brescia, 25123 Brescia, Italy.
FAU - Bertulli, Alice
AU  - Bertulli A
AD  - Department of Clinical and Experimental Sciences, University of Brescia, Bone 
      Marrow Transplant Unit, ASST-Spedali Civili di Brescia, 25123 Brescia, Italy.
FAU - Leali, Daria
AU  - Leali D
AD  - Central Laboratory, ASST-Spedali Civili Brescia, 25123 Brescia, Italy.
FAU - Bernardi, Simona
AU  - Bernardi S
AUID- ORCID: 0000-0002-3494-2624
AD  - Department of Clinical and Experimental Sciences, University of Brescia, Bone 
      Marrow Transplant Unit, ASST-Spedali Civili di Brescia, 25123 Brescia, Italy.
FAU - Russo, Domenico
AU  - Russo D
AD  - Department of Clinical and Experimental Sciences, University of Brescia, Bone 
      Marrow Transplant Unit, ASST-Spedali Civili di Brescia, 25123 Brescia, Italy.
LA  - eng
PT  - Journal Article
DEP - 20220831
PL  - Switzerland
TA  - Nutrients
JT  - Nutrients
JID - 101521595
RN  - 0 (Transforming Growth Factor beta2)
SB  - IM
MH  - *Graft vs Host Disease/etiology/prevention & control
MH  - *Hematopoietic Stem Cell Transplantation/adverse effects
MH  - Humans
MH  - *Malnutrition/etiology
MH  - Prospective Studies
MH  - Transforming Growth Factor beta2
PMC - PMC9460256
OTO - NOTNLM
OT  - GVHD
OT  - PG-SGA
OT  - TGF-beta2
OT  - allogeneic hematopoietic stem cell transplantation
OT  - malnutrition
COIS- This research was partially funded by Nestle Health Science (Italy) and 
      Associazione Italiana Leucemie (AIL-Sezione di Brescia) with a study grant for a 
      dietitian support for the department.
EDAT- 2022/09/10 06:00
MHDA- 2022/09/14 06:00
PMCR- 2022/08/31
CRDT- 2022/09/09 01:25
PHST- 2022/07/27 00:00 [received]
PHST- 2022/08/24 00:00 [revised]
PHST- 2022/08/25 00:00 [accepted]
PHST- 2022/09/09 01:25 [entrez]
PHST- 2022/09/10 06:00 [pubmed]
PHST- 2022/09/14 06:00 [medline]
PHST- 2022/08/31 00:00 [pmc-release]
AID - nu14173589 [pii]
AID - nutrients-14-03589 [pii]
AID - 10.3390/nu14173589 [doi]
PST - epublish
SO  - Nutrients. 2022 Aug 31;14(17):3589. doi: 10.3390/nu14173589.