Enteral versus parenteral nutritional support in allogeneic haematopoietic stem-cell transplantation

Guièze, Romain; Lemal, Richard; Cabrespine, Aurélie; Hermet, Éric; Tournilhac, Olivier; Combal, Cécile; Bay, Jacques‐Olivier; Bouteloup, Corinne

doi:10.1016/j.clnu.2013.07.012

Cited by 88 publications

(83 citation statements)

References 26 publications

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“…Using the gut might be beneficial to maintain its integrity or improve glucose control, which may reduce the risk of GVHD [41,42,44]. Other groups also reported feasibility and promising results of using EN after HSCT [45][46][47]. The major limitation of EN in HSCT is the difficulty of inserting EN tubes in patients with severe mucositis or gastrointestinal tract damage.…”

Section: Nutritional Management During the Early Period After Hsctmentioning

confidence: 92%

Systematic Nutritional Support in Allogeneic Hematopoietic Stem Cell Transplant Recipients

Fuji

Einsele

Savani

et al. 2015

Biology of Blood and Marrow Transplantation

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Allogeneic hematopoietic stem cell transplantation (HSCT) has become an established treatment modality for various hematological diseases. However, in allogeneic HSCT, patients often suffer from severe gastrointestinal complications caused by the conditioning regimen and acute/chronic graft-versus-host disease, which requires support by multidisciplinary nutritional support teams (NST). In addition, pretransplantation nutritional status can affect the clinical outcome after allogeneic HSCT. Therefore, it is important to refer the patient to a NST when becoming aware of nutritional problems before allogeneic HSCT. It is also important to follow nutritional status over the long term, as patients often suffer from various nutritional problems, such as malnutrition and metabolic syndrome, even late after allogeneic HSCT. In summary, NST can contribute to the improvement of nutritional status and possibly prognosis at every stage before and after allogeneic HSCT. Here, we aim to give a comprehensive overview of current understanding about nutritional support in allogeneic HSCT and try to provoke a constructive discussion to stimulate further investigation.

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Section: Nutritional Management During the Early Period After Hsctmentioning

confidence: 92%

Systematic Nutritional Support in Allogeneic Hematopoietic Stem Cell Transplant Recipients

Fuji

Einsele

Savani

et al. 2015

Biology of Blood and Marrow Transplantation

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“…Compared with PN, EN was associated with a lower risk of infection in allo-HSCT, without an increase in the incidence of GVHD [19]. The ESPEN guideline suggests preferring enteral tube feeding over PN unless there are severe problems associated with HSCT due to inadequate oral nutrition [18].…”

Section: Discussionmentioning

confidence: 99%

Low Body Mass Index and Myeloablative Conditioning Regimen Prolong the Duration of Parenteral Nutrition During Hematopoietic Stem Cell Transplantation

et al. 2019

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Background/Aims: Patients undergoing hematopoietic stem cell transplantation (HSCT) often receive total parenteral nutrition (TPN) due to poor oral intake. In clinical practice, it is difficult to predict adequate nutritional management, especially the duration of parenteral nutrition (PN), because of inter-individual variability in the conditions and types of treatment regimens. This study investigated the relationship between patient factors and the duration of TPN and the duration of PN. Methods: Data on clinical features, patient characteristics, and the duration of TPN and PN were collected from medical records of 61 of 73 patients who underwent HSCT between April 2010 and December 2014 and were analyzed by multiple linear regression analysis. Results: Forty-nine patients (80.3%) received TPN and 53 (86.9%) received PN. Sixty patients were affected by poor oral intake soon after pretreatment. Body mass index (BMI) was significantly correlated with the duration of TPN (β = –2.733; 95% CI –4.679 to –0.787). BMI (β = –2.260; 95% CI –4.304 to –0.213) and conditioning regimen (β = 12.726; 95% CI 0.692–24.76) were significantly correlated with the duration of PN. Conclusions: BMI at admission and the type of conditioning regimen should be considered in choosing the nutritional management plan in patients with HSCT with poor oral intake.

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“…Patients with diarrhea had stool analysis negative for virus, bacteria, fungi, and protozoa. Total PN was initiated to all patients after the diagnosis of GI-GVHD and also minimal enteral nutrition (1-2 ml/kg/day standard pediatric enteral formula/special meat soup) was given to the patients to prevent development of intestinal atrophy 14 . TPN was infused via a CVC overnight, for a minimal duration of 12 hours.…”

Section: Gvhd-mentioning

confidence: 99%

Stepwise diet management in pediatric gastrointestinal graft versus host disease

Koç¹,

Gündüz²,

Azık³

et al. 2016

Turk J Pediatr

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Gastrointestinal tract is one of the major systems affected by graft-versus-host disease (GVHD). Injury to the gut during conditioning therapy before stem-cell transplantation (SCT) plays a pivotal role in the initiation of inflammatory stimuli. We reviewed medical records of the patients who underwent SCT between April 2010 and June 2013 in our center. A stepwise upgrade diet was given to the children with acute GI-GVHD (Gastrointestinal GVHD) including parenteral and enteral nutrition. A total of 105 patients underwent SCT and seven patients developed grade III-IV acute GI-GVHD. Total parenteral nutrition (TPN) was initiated to all patients after the diagnosis of GI-GVHD and minimal enteral nutrition (1-2 ml/kg/day standard pediatric enteral formula/special meat soup) was given to the patients. GI-GVHD improved in all patients with no change in body weight, and recovery to a normal diet took 10-30 days. Stepwise diet management of oral nutrition contributed to rapid improvement of grades III-IV acute GI-GVHD.

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Enteral versus parenteral nutritional support in allogeneic haematopoietic stem-cell transplantation

Cited by 88 publications

References 26 publications

Systematic Nutritional Support in Allogeneic Hematopoietic Stem Cell Transplant Recipients

Systematic Nutritional Support in Allogeneic Hematopoietic Stem Cell Transplant Recipients

Low Body Mass Index and Myeloablative Conditioning Regimen Prolong the Duration of Parenteral Nutrition During Hematopoietic Stem Cell Transplantation

Stepwise diet management in pediatric gastrointestinal graft versus host disease

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