ACUTE myeloid leukaemia (AML) and myelodysplastic syndrome (MDS) commonly affect adults aged 55 and over. Treatments can be intensive, and result in many side effects that impact a patient’s ability to eat, and thus to maintain an optimal nutritional status.
A research team, led by Victoria Crowder, University of North Carolina, Chapel Hill, USA, sought to conduct a scoping review to explore eating and nutritional challenges among older adults with AML and MDS, as well as to explore the effects of these challenges on physical and psychosocial health and quality of life.
PubMed, CINAHL, and Scopus databases were searched, identifying English, peer-reviewed, empirical studies that discussed nutrition in patients with AML and MDS. Twelve studies, published between 2010–2022, were included in the final review (eight retrospective, two prospective cohorts, one prospective intervention, and one not reported), with eight investigating AML, three MDS, and one investigating both. The majority of studies assessed nutrition using the Mini Nutritional Assessment or BMI at admission for chemotherapy or stem cell transplant.
Chemotherapy is associated with nausea, vomiting, fatigue, and diarrhoea, which all significantly impact a patient’s quality of life and nutrition. The researchers identified several nutritional challenges in the study cohort, including malnutrition, sarcopenia, weight loss, impaired BMI, and impaired renal function. These challenges could be associated with impairments to physical function, increased prevalence of comorbidities, and even impaired survival. Results also showed that one-third of patients with AML were found to be at greater risk of malnutrition, while one-third of patients with MDS had ≥2% weight loss before they were admitted for stem cell transplantation.
Overall, researchers concluded that the study identified nutritional challenges among AML and MDS patients in this cohort. However, they acknowledge that multiple gaps exist in the literature. None of the studies reported the effects of eating and nutritional challenges on psychosocial outcomes. Similarly, no studies reported on the health of caregivers, who are an influential support system. Furthermore, only one study reported patient ethnicity. The researchers hope that these gaps will be addressed by future research.
