A Look at the Nutritional Impacts of an AML or MDS Diagnosis

Patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) often face nutritional challenges which can be associated with physical functioning impairments, increased risk of other health complications and even potentially impaired survival, according to recent research presented at the Oncology Nursing Society Annual Congress.

Researchers reviewed 12 prior studies on the effects that AML or MDS had on eating (such as decreased food intake or taste preference changes), mealtimes (ability to prepare meals or the impact of changed family relationships) and nutrition (impaired nutrient absorption) in patients aged 60 or older.

“For patients with AML or MDS, the disease and side effects of treatment have the potential to cause challenges for eating and mealtimes and maintaining nutritional status,” study author Victoria R. Crowder, a nurse at the University of North Carolina at Chapel Hill, said while presenting the findings. “The purpose of our review was to synthesize these potential challenges and understand the effects of challenges on physical health, psychosocial health — such as anxiety or depression — and quality of life.”

The studies found that approximately one-third of patients were at a risk for malnutrition at baseline, which is either the start of the study or the start of treatment. Further, considering that between 46% and 98% of patients with AML or MDS experience fatigue, they may experience changes in mealtimes or food intake.

Additionally, the following risk factors were shown to correlate with challenges in eating, mealtimes and/or nutrition:

• Malnutrition
• Sarcopenia (loss of muscle mass, strength and function)
• Impaired body mass index
• Weight loss
• Impaired kidney function

Interestingly, there was no relationship between treatment side effects and nutritional assessment scores.

"It was also no surprise to see a rich relationship between nutrition and physical functioning (in patients with AML or MDS)," Victoria R. Crowder said.

“Survival had mixed relationships with nutrition, and for patients with sarcopenia who were older adults, there were worse odds of survival,” Crowder said. “It was also no surprise to see a rich relationship between nutrition and physical functioning, which has been well-described in prior literature. Also, patients with more comorbidities had more gastrointestinal complications during treatment.”

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Of note, the researchers said they did not find any research that analyzed the potential relationship between nutritional status and psychosocial outcomes or the health of caregivers.

Based on these findings, the research team said that more research is needed in this area, and that patient-provider conversations regarding nutrition, eating and mealtimes is essential for individuals with AML or MDS.

“We hope that a greater understanding of the challenges facing patients with AML and MDS may inform practice help clinicians screen for challenges and address these challenges, and also to help them address the role these challenges can play in health and quality of life,” Crowder said.

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