Congresso Internacional do GRAACC

Dados do Trabalho


Handgrip Strength in Pediatric Patients Undergoing Hematopoietic Stem Cell Transplantation


Introduction: Nutritional status may affect outcomes of children with cancer. Handgrip strength is a quantitative measure of muscle strength function, which, with easy and non-invasive access, helps in the early identification of malnutrition. This method has not been evaluated in children undergoing hematopoietic stem cell transplantation (HSCT). Objective: To quantify muscle strength and investigate its possible association with anthropometric nutritional status and length of treatment prior to HSCT in children undergoing HSCT. Methods: Cross-sectional study of children undergoing HSCT between May 2019 and June 2022. Handgrip strength was measured before HSCT with a Baseline hydraulic dynamometer. The outcome variable was the handgrip z-score. Potential exposure variables for the outcome were the z-score of body mass index (BMI)/age and length of treatment prior to HSCT. Results: Forty-eight children aged 11.8 (3.7) years old were included, with the main diagnoses being acute myeloid leukemia and acute lymphoblastic leukemia (68.3% of the total). The median and interquartile range (IQR) length of treatment prior to HSCT was 17.13 (10.5; 32.5) months. Median (IQR) BMI/age and handgrip z-scores were 0.39 (0.69; 1.64) and - 0.78 (-1.89; 0;04) respectively. Handgrip z-score was < -2 in 23% of the patients. There was a positive correlation between BMI/age and handgrip z-scores (Spearman rho= 0. 32, p < 0.025). BMI/age z-scores (β coefficient: -0.24; 95% C.I.: 0.02; 0.45, p=0.03), but not duration of treatment prior to HST (p=051) were associated with handgrip strength z-scores in the linear regression analysis. Conclusion: Low muscle strength affects approximately one in four pediatric patients undergoing HSCT. Muscle strength is weakly correlated with BMI/age, and is not associated with the duration of treatment in children prior to HSCT.




Cláudia Georgiadis Lewandowski, Adriana Garófolo, Heitor Pons Leite