ZHOU Qian,WANG Lihong,HE Hua, et al. Nutritional status fluctuation and influencing factors in patients with multiple myeloma during induction chemotherapy[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2024, 54(10): 783-790.
Abstract：Objective: To observe prospectively and analyze the fluctuation of nutritional status and its changing regularity in patients with multiple myeloma during induction chemotherapy and to explore the influencing factors of malnutrition. Methods: A total of 140 newly diagnosed patients with multiple myeloma in the Second Affiliated Hospital of Air Force Medical University from January 2019 to December 2022 were selected as the research subjects. Patient-generated subjective global assessment (PG-SGA) score, BMI and serum albumin (ALB) were used to evaluate nutritional status of patients at 5 time points before chemotherapy and during chemotherapy cycles 1-4. Repeated measures analysis of variance was used to analyze the fluctuation trend of nutritional status in patients with multiple myeloma during induction chemotherapy, and generalized estimating equation was used to analyze the potential influencing factors of malnutrition. Results: A total of 136 patients completed 5 surveys, and the incidence of malnutrition fluctuated between 37.50% and 56.62% during induction chemotherapy. The PG-SGA score of the patients decreased first and then increased (P<0.001). At the same time, BMI and ALB increased first and then decreased (P<0.001), but subgroup analysis showed that the ALB level of patients with efficacy ≥PR in the late stage of induction chemotherapy showed an upward trend (P<0.001). The PG-SGA malnutrition of multiple myeloma patients during the whole induction chemotherapy
period was affected by age, initial malnutrition, hospital anxiety and depression scale (HADS score), infection after chemotherapy, efficacy and nutritional support (P<0.05); Malnutrition based on BMI was affected by age,Pittsburgh sleep quality index, HADS score, disease stage, initial malnutrition and nutritional support (P<0.05);The malnutrition under ALB standard was affected by age, efficacy, infection after chemotherapy, disease stage and nutritional support (P<0.05). Conclusion: There’s a trend of dynamic change during the phase of induction chemotherapy in patients with multiple myeloma. Elderly multiple myeloma patients in stage Ⅲ with sleep disorders, anxiety and depression, initial malnutrition, infection after chemotherapy, failure to achieve PR and no nutritional support are more prone to suffer from malnutrition, to whom more attention should be paid during induction chemotherapy.
