Phase angle from BIA as a prognostic and nutritional status tool for children and adolescents undergoing hematopoietic stem cell transplantation

Background & aims: The phase angle (PA) has been considered a prognostic and nutritional status indicator in several clinical situations considering its use as a body cell mass estimate value. The aim of this study was to evaluate the association between PA and other methods of nutritional assessment, as well as its prognostic value for children and adolescents undergoing hematopoietic stem cell transplantation (HSCT). Methods: The nutritional status of 67 patients and 35 controls was assessed by bioelectric impedance analysis and anthropometric measurements. The phase angle was calculated and expressed in degrees and standardized (SPA) according to reference values. The Kaplan-Meier method was used to calculate survival and Kappa coefficient to determine the concordance between the SPA and other parameters of nutritional assessment. The correlation was established by using Pearson's correlation analysis. Results: SPA progressively decreased during the treatment. The agreement between SPA and the diagnosis of malnutrition was moderate to %ideal weight, %TSF and %AMC and weak for BMI and weight/age z-score. Patients who had severe weight loss after transplantation had lower levels of SPA as compared to the group that did not lose weight (p < 0.001). Patients who developed chronic graft-versus-host disease had lower levels of SPA (p = 0.02), as well as patients who had been using corticosteroids during the post-transplant phase (p = 0.03). In this case, there was an inverse correlation between drug dose and SPA (p = 0.01). Patients with SPA <= 0 SD had a lower survival time as compared to the group of patients with SPA > 0 SD (p = 0.02) and showed an increased risk of death of 5.1 as compared to the other group (95% CI: 1.41-18.94). Conclusion: The present study suggests that SPA could be useful as an indicator of survival and nutritional status for patients undergoing HSCT. (C) 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.