Effect of total parenteral nutrition on marrow recovery during induction therapy for acute nonlymphocytic leukemia in childhood

Hays, Daniel M.; Merritt, Russell; White, Lynn Τ.; Ashley, Judith; Siegel, Stuart E.

doi:10.1002/mpo.2950110213

Cited by 60 publications

(24 citation statements)

References 19 publications

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“…Furthermore, a poor nutritional status has been associated with an impaired tumour response to treatment and outcome of disease (Donaldson et al, 1981;van Eys, 1982;Rickard et al, 1983a), reduced therapy tolerance van Eys, 1979;Filler et al, 1977;Hays et al, 1983;Rickard et al, 1983aRickard et al, , 1985, impaired immunological function (van Eys, 1979;van Eys et al, 1980) and a reduced state of well-being and performance (Donaldson et al, 1981;van Eys, 1979;Mauer et al, 1990). The aim of nutritional intervention must therefore be the prevention of therapy-related malnutrition and the added effects of protein energy malnutrition (PEM).…”

Section: Discussionmentioning

confidence: 99%

“…Naso-gastric tube feeding in children with cancer E den Broeder et al Several factors might have contributed to this: (1) The improved availability and ef®cacy of anti-emetics over the past few years has obviously led to better control of the adverse side-effects during courses of chemotherapy; (2) A poor nutritional status of a child with cancer leads to reduced therapy tolerance van Eys, 1979;Filler et al, 1977;Hays et al, 1983;Rickard et al, 1983aRickard et al, , 1985. The nutritional status of the children in the retrospective group was poorer than that in the experimental group at the same point during treatment, which might account for the difference in severity and frequency of vomiting; (3) Protocolized administration of tube feeding leads to optimisation of anti-emetic protocols, as the goal is to be able to administer suf®cient amounts of energy to provide the child's TDER.…”

Section: Discussionmentioning

confidence: 99%

“…Administration of parenteral nutrition (energy) to children with cancer during the initial phase of treatment can maintain or improve their nutritional status, immunity and treatment tolerance. Intensive nutritional counselling was unable to achieve this van Eys et al, 1979van Eys et al, , 1980Filler et al, 1977Filler et al, , 1979Ghavimi et al, 1982;Hays et al, 1983;Rickard et al, 1979Rickard et al, , 1980Rickard et al, , 1983bRickard et al, , 1985Szeluga et al, 1987). Nutritional counselling, with the aim of increasing oral energy intake, was only successful in maintaining an adequate nutritional status after the initial phase of treatment and during maintenance therapy (Rickard et al, 1980(Rickard et al, , 1985.…”

Section: Introductionmentioning

confidence: 99%

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Effects of naso-gastric tube feeding on the nutritional status of children with cancer

Broeder

Lippens

Hof³

et al. 1998

Eur J Clin Nutr

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Objective: To study the effect of suf®cient energy intake, by means of the protocolized administration of nasogastric tube feeding, on the nutritional status of a child with cancer. Design: A comparative experimental study. Setting: Tertiary care at the Centre for Pediatric Oncology, South East Netherlands, University Hospital, Nijmegen. Subjects: Seven children, newly diagnosed with cancer, were included in the experimental study and all completed the trial period. Fourteen patients were included in the retrospective study. They were randomly chosen from a group of patients previously treated for a malignancy at our department and who had received naso-gastric tube feeding for at least 16 weeks. Intervention: Protocolized (experimental group) vs non-protocolized (retrospective group) administration of naso-gastric tube feeding over a period of 16 weeks. The main difference was the amount of tube feeding administered. In addition to energy from other foods, children in the experimental group received 106 AE 13% of their total daily energy requirements (TDER) by means of tube feeding, whereas children in the retrospective group had received 75 AE 24%. Main outcome measures: Weight as a percentage of weight for height according to the 50th percentile of a healthy reference population ideal weight. Results: Weight, expressed as a percentage of the ideal weight, increased signi®cantly in the experimental group (18.2 AE 8.4; P 0.01) and the retrospective study group (5.2 AE 7.3; P 0.001). However, the increase was statistically signi®cant in favour of the experimental group (P 0.003), in which all the children reached their ideal weight, compared to 21% in the retrospective group. Conclusion: Aggressive protocolized nutritional intervention during the intensive phase of anti-cancer treatment, in the form of naso-gastric tube feeding that provides the child's total daily energy requirements, results in considerable improvement in the nutritional status.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of naso-gastric tube feeding on the nutritional status of children with cancer

Broeder

Lippens

Hof³

et al. 1998

Eur J Clin Nutr

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“…The role of conventional diet in maintaining nutritional status during insult A number of studies have shown that conventional feeding with added supplements is insuf®cient in preventing or reversing weight loss in children with leukaemia ± lymphoma (Hays et al, 1983), Wilms' tumours (Rickard et al, 1980), advanced neuroblastoma (Rickard et al, 1985), and a variety of tumours requiring abdominal irradiation (Donaldson et al, 1984). Rickard et al reported a deterioration in the nutritional status of children with Wilm's tumour who did not receive PN compared with those who did (Rickard et al, 1980).…”

Section: Nutritional Intervention Following Bmt: Which Route?mentioning

confidence: 99%

“…However, the nutritional bene®ts from the use of PN in these patients and its role in the outcome and survival are questioned. Hays et al compared outcomes, including maintenance of body cell mass and response to skin test antigens, in children with leukaemia who received PN and those who received a standard diet (Hays et al, 1983). White blood cell granulocyte and platelet counts were higher in the patients receiving PN without any reduction in the incidence of febrile episodes or the clinical outcome.…”

Section: The Role Of Parenteral Nutrition (Pn)mentioning

confidence: 99%

Nutritional considerations in children undergoing bone marrow transplantation

Papadopoulou

1998

Eur J Clin Nutr

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Bone marrow transplantation is often associated with multiple organ failure which is usually reversible. Oral mucositis and dysphagia, vomiting, diarrhoea, protein losing enteropathy, transient exocrine pancreatic impairment, hypoalbuminaemia, biochemical trace element and mineral de®ciencies are all common following transplantation and have profound nutritional consequences. Malnutrition affects negatively the clinical outcome. Nutritional support is provided to malnourished patients and those who suffer deterioration in nutritional status despite the provision of dietetic counselling. Only a few randomised studies comparing enteral with parenteral nutrition after transplant exist. Both enteral tube feeding (in the absence of mucositis) and parenteral nutrition are effective in maintaining nutritional status. However, enteral nutrition is associated with a better nutritional response and fewer complications than parenteral. With existing enteral and parenteral nutrition regimens close monitoring of trace element and mineral status is required.

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Critical evaluation of the role of nutritional support with chemotherapy

Chlebowski¹

1985

Cancer

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Although weight loss has an adverse impact on cancer patient survival, the ability of caloric provision via total parenteral nutrition (TPN) to favorably influence outcome in chemotherapy‐treated populations is not established. In randomized trials, no significant improvement in either response or survival was associated with TPN addition to chemotherapeutic treatment of adult patients with lymphoma, sarcoma, colon cancer, adenocarcinoma and small cell carcinoma of the lung, or testicular carcinoma. In two instances, TPN addition was associated with decreased survival, again raising the concern that caloric support in the absence of effective antitumor therapy might stimulate cancer growth. In any event, the hypothesis that nutritional repletion of a malnourished cancer patient receiving chemotherapy will improve clinical outcome remains to be critically tested, as studies demonstrating sequential improvement in lean body mass have not been reported. Most recently, consideration of potential mechanisms underlying the development of cancer cachexia has led to new strategies for nutritional intervention. For example, hypogonadism or low testosterone levels have been described in male patient populations with advanced cancer and correlated with weight loss and adverse outcome, leading to trial of replacement therapy with nandrolone decanoate. Similarly, the frequent identification of abnormal glucose metabolism in the patients with cancer cachexia has stimulated clinical trials with agents such as hydrazine sulfate and insulin designed to reverse the metabolic abnormality. Whether such efforts designed to alter metabolic abnormalities associated with cancer cachexia will improve clinical outcome will be determined in ongoing clinical trials.

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Effect of total parenteral nutrition on marrow recovery during induction therapy for acute nonlymphocytic leukemia in childhood

Cited by 60 publications

References 19 publications

Effects of naso-gastric tube feeding on the nutritional status of children with cancer

Effects of naso-gastric tube feeding on the nutritional status of children with cancer

Nutritional considerations in children undergoing bone marrow transplantation

Critical evaluation of the role of nutritional support with chemotherapy

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