Assessing the impact of nutritional status at allogeneic stem cell transplantation on clinical outcomes

Support Care Cancer. 2026 Jun 11;34(7):645. doi: 10.1007/s00520-026-10874-w.

ABSTRACT

PURPOSE: Nutritional status at allogeneic hematopoietic cell transplantation (HCT) can significantly impact outcomes, but conflicting results are reported.

METHODS: We investigate the role of nutritional status on HCT outcomes in 158 patients, including diabetes, body mass index (BMI), nutritional risk index (NRI) and the patient-generated subjective global assessment (PG-SGA).

RESULTS: PG-SGA was scored as A (well nourished) in 52%, B (risk of malnutrition or moderate malnutrition) in 44% and C (severely malnourished) in 4%. NRI was mild in 14 (9%), moderate in 33 (21%) and severe in 4 (3%) patients. Oral nutritional support and total parenteral nutrition was used during hospitalization in 86% and 36% patients. The cumulative incidence of grade II-IV acute graft-versus-host disease (GvHD) at 100 days was 20% (95% CI 14-27%). At 30 months, chronic GvHD was 17% (95% CI 12-24%), non-relapse mortality (NRM) was 25% (95% CI 19-33%) and relapse incidence (RI) was 24% (95% CI 18-32%). Overall survival and progression-free survival were 57% (95% CI 49-64%) and 50% (95% CI 42-58%) at 30 months. Patients with a median BMI above the median (median BMI = 25.87 kg/m2) had a lower risk of both acute (HR 0.42, 95%CI 0.12-0.92, p = 0.03) and chronic (HR 0.42, 95%CI 0.19-0.90, p = 0.02) GvHD in multivariate analysis. No statistical differences were found according to PG-SGA and NRI.

CONCLUSIONS: Our findings highlight the critical role of pre-transplant metabolic evaluation, personalized nutritional support, and optimal glycemic regulation in HCT care. Further large-scale studies are required to determine the association between nutritional status and HCT outcomes.

PMID:42277329 | DOI:10.1007/s00520-026-10874-w