Purpose

Differences in body weight changes and serum liver tests (LTs) in acute myeloid leukemia (AML) patients receiving parenteral nutrition (PN) versus no PN during remission induction (RI) treatment were assessed.

Methods

Retrospectively, differences in body weight changes and serum LTs in AML patients (n = 213) who received PN versus no PN during RI treatment in one of three Dutch hospitals between 2004 and 2015 were assessed. Weekly body weight and serum LT registrations were collected from medical records. Patients’ body weight changes were compared between the hospitals where PN is applied upon first indication of inadequate oral intake (PN hospitals) and the hospital where use of PN is limited to severe cases only (no-PN hospital) using repeated measures mixed model analysis. Differences in severity of serum LT elevations, according to the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0, were assessed between patients who did and did not receive PN using chi-square or Fisher’s exact tests, and multiple logistic regression analysis.

Results

Compared with patients of the PN hospitals, patients of the no-PN hospital experienced significantly more body weight loss during RI treatment (between-group difference 7.2%, 95% CI 4.0–10.3%). Furthermore, PN was associated with transient mild to moderate elevations of liver enzymes, but not with raised median total bilirubin levels nor with occurrence of CTCAE grade 3–4 LT elevations.

Conclusion

Frequent compared with exceptional use of PN in AML patients during RI treatment better preserved body weight, without clinically relevant (CTCAE grade 3–4) elevations in serum LTs.

中文翻译：

---

缓解诱导治疗期间急性髓细胞性白血病患者的体重和血清肝试验的变化与肠胃外营养相比无肠外营养。

目的

评估缓解诱导（RI）治疗期间接受肠外营养（PN）与无PN的急性髓细胞性白血病（AML）患者的体重变化和血清肝试验（LT）差异。

方法

回顾性分析，AML患者的体重变化和血清LTs差异（n = 213）评估了2004年至2015年间在荷兰三所医院之一中接受RI治疗期间接受PN与未接受PN的比较。从医疗记录中收集每周体重和血清LT登记。通过重复测量混合模型分析，比较了首次发现口服摄入量不足时应用PN的医院（PN医院）与仅使用PN仅限于严重病例的医院（无PN医院）之间患者的体重变化。 。根据公共不良事件术语标准（CTCAE）4.0版，使用卡方检验或Fisher精确检验以及多重逻辑回归分析评估了接受和未接受PN的患者之间血清LT升高的严重程度差异。

结果

与PN医院的患者相比，无PN医院的患者在RI治疗期间体重减轻明显更多（组间差异7.2％，95％CI 4.0-10.3％）。此外，PN与肝酶的轻度至中度短暂升高有关，但与总胆红素中位数升高或CTCAE 3-4级LT升高无关。

结论

在RI治疗期间，与AML患者中PN的异常使用相比，经常使用PN可以更好地保持体重，而血清LTs没有临床相关的升高（CTCAE 3-4级）。