Gastrointestinal problems persist for years after bone marrow transplantation

Blood cancers

8 Sep 2016

Gastrointestinal symptoms ranging from dry mouth to diarrhoea can remain problematic for many years after a successful bone marrow transplant and can undermine quality of life, a study of New South Wales survivors has shown.

Dietitian Jennifer Smith, from the Royal North Shore Hospital in Sydney, and colleagues analysed responses to a comprehensive survey completed by 441 adults who had a bone marrow transplant (BMT) between 2000 and 2012. They had the procedure a median of five years earlier.

Early GI side effects were common, with almost half of respondents reporting an altered taste and a dry mouth, 36% reporting mouth ulcers and 33% reporting an altered smell less than 2 years post-transplant.

The high prevalence of mouth ulcers and a dry mouth persisted across the three time periods analysed (<2 years, 2-5 years and >5 years).

Alterations in smell and taste declined over time, but were still a problem for 25% and 16% of respondents, respectively, after 5 years. Similarly, the prevalence of poor appetite declined from 28% to 18%.

The proportion reporting diarrhoea remained consistent at about 19% regardless of time since transplant, but the rate of nausea and vomiting declined substantially.

Quality of life, assessed by the FACT-BMT questionnaire, declined in direct proportion to the number of gastrointestinal symptoms reported.

About 48% of the study population were either overweight or obese, compared to 63% of the general Australian population.

“Although BMI scores did not correlate to quality of life outcomes, the fact that almost half of the long-term survivors are overweight and obese remains a significant concern as this adds to comorbidities including metabolic syndrome, accelerated vascular disease, diabetes mellitus and musculoskeletal disorders,” Ms Smith and her colleagues wrote in Supportive Care in Cancer.

“The importance of nutrition support prior to and during the transplant phase is well recognised,” Ms Smith told the limbic.

“The strong links between nutrition and quality of life outcomes identified in this study highlights the importance of ongoing nutritional therapy and provides further support for the role of the dietitian within a comprehensive multi-disciplinary survivorship clinic setting.

“Future studies might like to investigate the effectiveness of nutrition therapy in managing nutritional issues in this patient group and how this impacts on survivor’s quality of life,” she added.


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