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Objective: The aim of this study was to assess the agreement between detected changes in body composition determined by bioimpedance spectroscopy (BIS) and air-displacement plethysmography (ADP) among patients with cancer undergoing peripheral blood stem cell transplantation (PBSCT); and to assess the agreement of absolute values of BIS with ADP and dual energy x-ray (DXA)., Methods: Forty-four adult hematologic cancer patients undergoing PBSCT completed both BIS and ADP assessment at preadmission and at 3 mo after transplantation. A subsample (n = 11) was assessed by DXA at 3 mo after transplantation. Results were examined for the BIS instrument's default setting and three alternative predictive equations from the literature. Agreement was assessed by the Bland-Altman limits of agreement analysis while correlation was examined using the Lin's concordance correlation., Results: Changes in body composition parameters assessed by BIS were comparable with those determined by ADP regardless of the predictive equations used. Bias of change in fat-free mass was clinically acceptable (all <1 kg), although limits of agreement were wide (more than ±6 kg). Overall, the BIS predictive equation accounting for body mass index performed the best. Absolute body composition parameters predicted by the alternative predictive equations agreed with DXA and ADP better than the BIS instrument's default setting., Conclusion: Changes predicted by BIS were similar to those determined by ADP on a group level; however, agreement of predicted changes at an individual level should be interpreted with caution due to wide limits of agreement., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Purpose: This pilot exploratory study aimed to describe the changes in nutritional status, body composition, quality of life (QoL), and physical activity levels (PAL) of cancer patients undergoing high-dose conditioning and autologous peripheral blood stem cell transplantation (PBSCT) at pre-admission, hospital discharge, and at 100 days post-transplantation, and to examine if changes in these parameters are interrelated. Methods: Twenty-four patients (56.2 ± 12.9 years; 7 females, 17 males) were recruited from an Australian transplant center. Assessment was prospectively conducted at pre-admission, hospital discharge, and 100 days post-transplantation using the scored patient-generated subjective global assessment, air displacement plethysmography, EORTC QLQ-C30 (version 3), and the international physical activity questionnaire. Results: At discharge, nutritional status deteriorated (patient-generated subjective global assessment (PG-SGA) median, +8.0; interquartile range, 6.0-13.0; p < 0.001) and the number of malnourished patients increased ( n = 8/23; p = 0.023). Patients experienced significant loss of lean body mass (LBM; −2.2 kg, CI 95 % −3.0, −1.4; p < 0.001), and decrease in QoL (−10.6, CI 95 % −24.1, 2.9; p = 0.117); the proportion of patients with high PAL decreased ( p = 0.012). By 100 days post-transplantation, all patients were well-nourished; however, LBM remained lower −1.0 kg (CI 95 % −1.9, −0.1; p = 0.028). Change in nutritional status (PG-SGA score) was associated with weight ( r = −0.46; p = 0.039) and fat mass ( r = −0.57; p = 0.013). Change in QoL was associated with nutritional reservoir (i.e., fat; r = 0.54; p = 0.024); QoL was consistently higher for patients with high PAL. Conclusions: High-dose conditioning and autologous PBSCT is associated with deterioration in nutritional status, QoL and PAL, with LBM remaining below baseline levels at 100 days post-transplantation. A nutrition and exercise intervention program post-hospital discharge may be beneficial for these patients. [ABSTRACT FROM AUTHOR]

Alpha interferon has proven efficacy in prolonging remissions in patients with follicular non-Hodgkin lymphoma (NHL) when given concurrently with or after conventional-dose anthracycline-based chemotherapy, but there are limited data on its use after myeloablative conditioning. We prospectively evaluated the toxicity and efficacy of interferon given thrice weekly for up to 5 years post-engraftment in patients with relapsed follicular NHL undergoing autologous stem cell transplant using busulfan–melphalan conditioning. Thirty-seven patients were enrolled in this Australasian Leukaemia & Lymphoma Group study and transplanted between 1995 and 1999. Only one patient had received prior rituximab. Two patients died of transplant-related toxicity; 28 of the remainder commenced interferon, but it was discontinued prematurely in most patients due to toxicity (mainly fatigue and depression) or relapse. While the majority of patients (29/36 evaluable: 81%) achieved a complete remission based on clinical and CT scan criteria post-transplant, most relapsed relatively early, with a median progression-free survival of 2.4 years. The overall survival at 7 years was 49%. Eight patients (22%), however, remain alive a median of 9.3 years post-transplant, having never relapsed, and another six patients (16%) remain alive in durable remission after salvage therapy. These results demonstrate that interferon is poorly tolerated post-autograft and hence is unlikely to positively contribute to patient outcome. Long-term follow-up demonstrates that autografting may result in durable remissions in a meaningful minority of patients with relapsed follicular NHL. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to assess the agreement between detected changes in body composition determined by bioimpedance spectroscopy (BIS) and air-displacement plethysmography (ADP) among patients with cancer undergoing peripheral blood stem cell transplantation (PBSCT); and to assess the agreement of absolute values of BIS with ADP and dual energy x-ray (DXA). Methods: Forty-four adult hematologic cancer patients undergoing PBSCT completed both BIS and ADP assessment at preadmission and at 3 mo after transplantation. A subsample (n = 11) was assessed by DXA at 3 mo after transplantation. Results were examined for the BIS instrument's default setting and three alternative predictive equations from the literature. Agreement was assessed by the Bland-Altman limits of agreement analysis while correlation was examined using the Lin's concordance correlation. Results: Changes in body composition parameters assessed by BIS were comparable with those determined by ADP regardless of the predictive equations used. Bias of change in fat-free mass was clinically acceptable (all <1 kg), although limits of agreement were wide (more than ±6 kg). Overall, the BIS predictive equation accounting for body mass index performed the best. Absolute body composition parameters predicted by the alternative predictive equations agreed with DXA and ADP better than the BIS instrument's default setting. Conclusion: Changes predicted by BIS were similar to those determined by ADP on a group level; however, agreement of predicted changes at an individual level should be interpreted with caution due to wide limits of agreement. [ABSTRACT FROM AUTHOR]