Role of Parenteral Nutrition in Cancer Patients Undergoing High-Dose Chemotherapy Followed by Autologous Peripheral Blood Progenitor Cell Transplantation

Abstract

High-dose chemotherapy followed by autologous bone marrow or peripheral blood progenitor cell transplantation represents a recognized option in the treatment of solid tumors and hematologic diseases. Patients receiving high-dose chemotherapy are traditionally supported with parenteral nutrition with the aim to prevent malnutrition secondary to gastrointestinal toxicity and metabolic alterations induced by the conditioning regimens. Nevertheless, well-defined guidelines for its use in this clinical setting are lacking and there are several areas of controversy.

Effects of nutritional and psychological status in gastrointestinal cancer patients on tolerance of treatment

“…Patients receiving high-dose chemotherapy need to be supported with parenteral nutrition [1] . Nutrition therapy can help cancer patients get the nutrients to maintain body weight and performance status, prevent body tissue from breaking down and rebuild tissues [2] .…”

“…Poor psychological status, such as depression or anxiety, not only affects the appetite of patients, but also increases side-effects of treatment [7] and impacts well-being of patients [3] . The effects of nutrition on cancer treatment have been studied by many authors [1][2][3] . However, few studies have reported on the association between nutritional and psychological status in the gastrointestinal cancer patients prior to chemotherapy/radiotherapy and treatment tolerance [4,6] .…”

Nutrition support

“…45,57,58 Research in the 1980s and 1990s mainly concerned the use of PN, with many proponents advocating routine, prophylactic use. 45,57,58 Research in the 1980s and 1990s mainly concerned the use of PN, with many proponents advocating routine, prophylactic use.…”