A Multi-Center International Survey Related to the Nutritional Support after Hematopoietic Stem Cell Transplantation Endorsed by the ASIA Pacific Blood and Marrow Transplantation (APBMT)

Abstract

Background: The nutritional support after hematopoietic stem cell transplantation (HSCT) has not been well established due to the scarcity of clinical trials. To conduct international clinical trials in Asia, we performed the questionnaire survey to investigate the current standard of nutritional support after HSCT. Method: We sent the questionnaire to the physicians nominated by the Asia Pacific Blood and Marrow Transplantation (APBMT) members of each country/ region. Result: We received 15 responses from 7 different countries/regions. The target calorie amount is 1.0 -1.3 × basal energy expenditure (BEE) in 11 institutes when partial parenteral nutrition is used. When total parenteral nutrition (TPN) is used, the target calorie amount is 1.0 -1.3 × BEE in 9 institutes and 1.3 -1.5 × BEE in 4 institutes. Lipid emulsion is routinely used in 12 institutes. Multivitamins and trace elements are routinely added to TPN used in most institutes. It is still uncommon to use the immunonutrition. Blood glucose levels are routinely monitored in all institutes, but the target range varies (<110 in 2 institutes, <150 in 4 institutes, and <200 in 8 institutes). Conclusions: Basic nutritional support is similar in participating institutes. However, the target glucose level varies and the use of immunonutrition is rather rare. These points can be the theme of future clinical trials.

Variability of nutritional practices in peritransplant period after allogeneic hematopoietic stem cell transplantation: a survey by the Complications and Quality of Life Working Party of the EBMT

“…Our survey is in line with similar earlier surveys that demonstrated significant variations in nutritional therapy practices in patients undergoing HSCT as well as disregard of international guidelines. These studies confirmed different nutritional practices among transplant centers in Europe [16,17] and Asia [18]. Our survey further confirmed a marked variation of nutritional practices between EBMT centers.…”

Revisiting nutritional support for allogeneic hematologic stem cell transplantation—a systematic review

“…17 Owing to weak evidence for all recommendations, there is broad variability of current clinical practice guidelines, as well as discrepancy between hospital guidelines and international recommendation. [18][19][20] Many centers also lack a standardized strategy for nutritional support in these patients. 20 Since the publication of these guidelines in 2009, important studies on the role and impact of nutritional interventions on clinical outcomes in patients undergoing HSCT have been published.…”

Adherence to guidelines on nutrition support during intensive treatment of acute myeloid leukemia patients: A nationwide comparison

“…However, other elements recommended by ESPEN, i.e. body composition, physical activity and the degree of inflammation, were not routinely and uniformly monitored in both the current and previous surveys [19,20,22]. Noteworthy, although all RDs agreed that physical exercise and nutrition should be combined as one intervention to improve muscle mass, the latter was rarely assessed.…”