Reduced nutritional status among multiple myeloma patients during treatment with high-dose chemotherapy and autologous stem cell support

Background & aims: Multiple myeloma (MM) ranks among the most frequent blood cancers in adults. Optimal treatment consists of high-dose chemotherapy and autologous stem cell transplantation. Health-related quality of life (HRQoL) is reduced before, during, and after therapy. Several HRQoL items are associated with nutritional health, e.g., nausea/vomiting, appetite loss and fatigue. It is unknown whether nutritional status in MM is affected by treatment. Hence we assessed nutritional status before, during and 1/2 year after treatment-start. Methods: We applied anthropometry (height, weight, hand-grip strength, triceps skinfold) and plasma concentrations of biomarkers to assess nutritional status. HRQoL was determined with the EORTC QLQ-C30 questionnaire. Results: The anthropometrical parameters all decreased (p < 0.05) during treatment, but were restored at the end of the observation period. Albumin and the fat-soluble vitamins D and E followed a similar pattern, whereas transferrin and vitamin A were unchanged (p > 0.05). Interestingly, markers of thyroid function declined and remained low (p < 0.05) even 6 months after start of therapy. Nutrition-associated symptoms used as markers of HRQoL worsened during therapy, but returned to pre-therapy levels. Conclusion: Intensive therapy in MM is associated with a decline in both nutritional status and health-related quality of life. (C) 2009 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.