ESPEN 2021 Abstract Submission

Topic: Nutrition and cancer

Abstract Submission Identifier: ESPEN21-ABS-1239

THE RELATION BETWEEN FAT-FREE MASS AND SIDE EFFECTS INDUCED BY

CHEMOTHERAPY IN PATIENTS WITH LYMPHOMA – A PROSPECTIVE COHORT STUDY

S. K. Andersen^*, ¹, A.-L. M. G. Egeberg ¹, C. B. Poulsen ², J. R. Andersen ¹

¹Department of Nutrition, Exercise and Sports, UNIVERSITY OF COPENHAGEN, Copenhagen, ²Department of Haematology, Roskilde Hospital, Region Zeeland, Roskilde, Denmark

Rationale: As cytostatic agents are water soluble it has been suggested, that side-effects should be expected to be more  serious in patients with a modest lean-body-mass (LBM), and it has been suggested to use LBM for dose-calculation instead of surface.

Aim: We wanted to investigate if the occurrence of side-effects (dose limiting toxicity or treatment delaying toxicity or chemotherapeutic-induced side effects - DLT) are related to the dose/ kg LBM as well as compare the dose-calculation using body surface and LBM.

Methods: The prospective cohort study included 53 patients in myelosuppressive treatment for malignant lymphoma of various types. The patients received several different types of chemotherapy. The patients was observed over a minimum of two treatment series and had bioimpedance (BIA) measurements conducted at each treatment series together with interviews about side effects, physical activity, quality of life and 24-hour diet recall interview.

Results: There was no significant difference in the total change in FFM, FM and weight during the study period, but the patients lost more FFM than weight. There was no significant difference in the average total change in FFM across the study population parted into series-interval groups, risk groups and in patients who experienced DLT and no DLT. Significantly more women experienced DLT (p=0,02). The grade 0-1 for the presence of side-effcets was reported by > 50% of the patients. There were few significant trends between the groups in the correlations-test of dosis pr. kg. FFM, expressed as Body Surface Area (BSA)/FFM ratio, and side-effects. Decreased appetite, taste disturbances and stomatitis significantly correlated positively with BSA/FFM ratio in 2 out 7 series within the same group. Patients who experienced DLT had a significantly higher BSA/FFM ratio at 3 series (p=0,02-0,05). In addition, 3 cut-offs were estimated for the maximal tolerable BSA/FFM ratio: 0,038 m2/kg, 0,036 m2/kg og 0,037 m2/kg respectively. Over 50% of the patients had their percentage of energy and protein needs met >75% during the study period. Physical activity (PAL) decreased during the study period and was significantly lower for DLT patients vs. no DLT (p=0,04). In the evaluation of quality of life, patients who experienced DLT had a higher health status and lower symptom burden.

Conclusion: There was no evidence for a relationship between dose of cytostatic pr. kg. and FFM in patients with lymphoma.

Disclosure of Interest: None Declared

Keywords: cytostatic treatment, nutritional intake, Toxicity