SKELETAL-MUSCLE PROTEIN RESERVE AFTER BONE-MARROW TRANSPLANTATION IN CHILDREN

To evaluate the long-term profile of nutritional status in children un dergoing BMT, me carried out a 1-year follow-up of 42 consecutive pati ents. The skeletal muscle protein reserve was assessed by ultrasonogra phy, and by calculating the mid-arm muscle area from skinfold and arm circumference measurements. Ultrasonography proved to be superior to a nthropometry, During the first month after BMT, the skeletal muscle pr otein reserve decreased by 11% (95% CI -20 to -4%), and only began to recover gradually several months after BMT. The serum transferrin conc entration decreased significantly during the first post-transplant mon th, then slowly returned to normal by the end of the first post-transp lant year. The 23 patients with allogeneic transplants and 19 with aut ologous transplants were fully comparable in nutritional respects, Des pite total parenteral nutrition the total energy intake did not reach the weight-based target level. The patients in whom pretransplant prot ein energy reserves were severely reduced, were at increased risk of d ying of relapse. We conclude that ultrasonography is a valuable method for assessing protein energy reserves in BMT patients. Pretransplant nutritional status has a considerable impact on post-transplant surviv al. We emphasize the importance of both pre- and post-transplant nutri tional support.