Non-surgical oncology – Guidelines on Parenteral Nutrition, Chapter 19

Arends, Jann; Zuercher, G.; Dossett, A.; Fietkau, Rainer; Hug, Martin; Schmid, Irene; Shang, E.; Zander, Axel R.

doi:10.3205/000068

GMS German Medical Science; 7:Doc09; ISSN 1612-3174 2009

DOI: 10.3205/000068

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Non-surgical oncology – Guidelines on Parenteral Nutrition, Chapter 19

Jann Arends

G. Zuercher²,

A. Dossett³

et al.

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Cited by 3 publications

References 150 publications

(218 reference statements)

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Nutritional assessment as predictor of complications after hematopoietic stem cell transplantation

Espinoza

Perelli

Olmos

et al. 2016

Revista Brasileira de Hematologia e Hemoterapia

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IntroductionNutritional support is pivotal in patients submitted to hematopoietic stem cell transplantation. Nutritional status has been associated with time of engraftment and infection rates. In order to evaluate the association between nutritional parameters and clinical outcomes after transplantation a cohort of transplant patients was retrospectively evaluated.MethodsAll 50 patients transplanted between 2011 and 2014 were included. The nutritional status before transplantation, ten days after transplantation and before discharge was assessed including anthropometry, body mass index, albumin, prealbumin and total urinary nitrogen.ResultsThe median follow-up time was 41 months and the median age of patients was 41 years. Thirty-two underwent allogeneic and 18 autologous transplants. Diagnoses included acute leukemias (n = 27), lymphoma (n = 7), multiple myeloma (n = 13), and aplastic anemia (n = 3). Thirty-seven patients developed mucositis (three Grade 1, 15 Grade 2, 18 Grade 3 and one Grade 4), and twenty-two allogeneic, and five autologous transplant patients required total parenteral nutrition. Albumin and total urinary nitrogen were associated with length of hospital stay and platelet and neutrophil engraftment. None of the nutritional parameters evaluated were associated with overall survival. Non-relapse mortality was 14% and overall survival was 79% at 41 months of follow-up.ConclusionsAfter hematopoietic stem cell transplantation, high catabolism was associated with longer length of hospital stay, the need of total parenteral nutrition and platelet and neutrophil engraftment times. Nutritional parameters were not associated with overall survival.

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Nutritional assessment as predictor of complications after hematopoietic stem cell transplantation

Espinoza

Perelli

Olmos

et al. 2016

Revista Brasileira de Hematologia e Hemoterapia

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Association of Nutritional Parameters with Clinical Outcomes in Patients with Acute Myeloid Leukemia Undergoing Haematopoietic Stem Cell Transplantation

Baumgartner

Zueger²,

Bargetzi³

et al. 2016

Ann Nutr Metab

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Introduction: In acute myeloid leukemia (AML) patients undergoing allogeneic haematopoietic stem cell transplantation (HSCT), there is uncertainty about the extent of influence nutritional parameters have on clinical outcomes. In this study, we investigated the association between initial body mass index (BMI) and weight loss during HSCT on clinical outcomes in a well-characterised cohort of AML patients. Methods: We analysed data of the Basel stem-cell transplantation registry (‘KMT Kohorte') including all patients with AML undergoing first allogeneic HSCT from January 2003 to January 2014. We used multivariable regression models adjusted for prognostic indicators (European Group for Blood and Marrow Transplantation risk score and cytogenetics). Results: Mortality in the 156 AML patients (46% female, mean age 46 years) over the 10 years of follow-up was 57%. Compared to patients with a baseline BMI (kg/m²) of 20-25, a low BMI <20 was associated with higher long-term mortality (70 vs. 49%, adjusted hazard ratio 1.97, 95% CI 1.04-3.71, p = 0.036). A more pronounced weight loss during HSCT (>7 vs. <2%) was associated with higher risk for bacterial infections (52 vs. 28%, OR 2.8, 95% CI 0.96-8.18, p = 0.059) and fungal infections (48 vs. 23%, OR 3.37, 95% CI 1.11-10.19, p = 0.032), and longer hospital stays (64 vs. 38 days, adjusted mean difference 25.6 days (15.7-35.5), p < 0.001). Conclusion: In patients with AML, low initial BMI and more pronounced weight loss during HSCT are strong prognostic indicators associated with lower survival and worse disease outcomes. Intervention research is needed to investigate whether nutritional therapy can reverse these associations.

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Important Aspects of Nutrition in Children with Cancer

Bauer

Jürgens

Frühwald

2011

Advances in Nutrition

189

224

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Adequate nutrition during cancer plays a decisive role in several clinical outcome measures, such as treatment response, quality of life, and cost of care. However, the importance of nutrition in children and young adults with malignancies is still an underestimated topic within pediatric oncology. The importance of our work is to reinforce and indicate that malnutrition in children with cancer should not be accepted at any stage of the disease or tolerated as an inevitable process. Unique to our manuscript is the close collaboration, the exchange of knowledge and expertise between pediatric oncologists and a nutritional specialist, as well as the comprehension of the mechanisms during cancer cachexia and malnutrition. We provide a critical review of the current state of research and new knowledge related to nutritional management in childhood cancer. Adv. Nutr. 2: 67-77, 2011.

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Non-surgical oncology – Guidelines on Parenteral Nutrition, Chapter 19

Cited by 3 publications

References 150 publications

Nutritional assessment as predictor of complications after hematopoietic stem cell transplantation

Nutritional assessment as predictor of complications after hematopoietic stem cell transplantation

Association of Nutritional Parameters with Clinical Outcomes in Patients with Acute Myeloid Leukemia Undergoing Haematopoietic Stem Cell Transplantation

Important Aspects of Nutrition in Children with Cancer

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