TITLE

Blood and marrow transplantation and nutritional support

PUB. DATE
May 2010
SOURCE
Supportive Care in Cancer;May2010, Vol. 18 Issue 0, p57
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Introduction Undernourishment on hospital admission has been considered as risk factor for complications and increased relapse/nonrelapse mortality in hematopoietic stem cell transplantation (HSCT) patients. Materials and methods All patients undergoing HSCT are at an increased risk for malnutrition. The changes in these patients affect mainly protein, energy, and micronutrient metabolism. Nutrition support recommendations are now based on the nutritional status of the individual patient, and total parenteral nutrition is no longer indicated for all HSCT patients. As long as it is possible, an oral route should be use in feeding to avoid complications. When total parenteral nutrition (TPN) should be started is one of the most controversial issues. The following indications for TPN are now generally accepted: severe malnutrition at admission (BMI<18.5) or weight loss>10% during treatment or impossibility of oral feeding or failing to meet 60-70% of the requirements over 3 days. Specialized nutritional support containing glutamine or immunomodulatory formulas such as arginine, ω3 polyunsaturated fatty acids, purine/pyrimidines (RNA) may be useful. Result The complications of TPN are divided into metabolic and those related to central venous catheter. TPN should be progressively decreased while increasing feedings by the oral route. When the patients can cover ≥50% of the daily energy requirements orally (for greater than 5 days), withdrawal of TPN may be appropriate. In patients who have suffered from graft-versus-host disease (GvHD) with intestinal involvement, TPN should be used until the stool volume decreases to <500 ml/day for at least 2 days. Conclusion Parenteral nutrition allows better modulation of fluid, electrolytes, and nutrient administration which can be of critical importance when complications such as GvHD or VOD arise.
ACCESSION #
49124329

 

Related Articles

  • Clinical effect of individualized parenteral nutrition vs conventional method in patients undergoing autologous hematopoietic SCT. Tavakoli-Ardakani, M; Neman, B; Mehdizadeh, M; Hajifathali, A; Salamzadeh, J; Tabarraee, M // Bone Marrow Transplantation;Jul2013, Vol. 48 Issue 7, p958 

    Malnutrition in patients undergoing hematopoietic SCT is known as a risk factor for adverse effects and is directly or indirectly responsible for excess mortality and morbidity. We designed the present study to evaluate the effects of individualized parenteral nutrition (PN) and compare the...

  • 23. Selected Aspects.  // Bone Marrow Transplantation;3/2/2002 Supplement, Vol. 29 Issue 5, pS237 

    Bone Marrow Transplantation (2001) 29, Suppl. 2, S237–S240. DOI: 10.1038/sj/bmt/1703492

  • Hematopoietic stem cell transplantation in Lebanon: first comprehensive report. Bazarbachi, A.; Hatoum, H. A.; Mugharbel, A.; Otrock, Z. K.; Yassine, N.; Muwakkit, S.; Salem, Z.; Shebbo, W.; Jisr, T.; Abboud, M.; Ibrahim, A. // Bone Marrow Transplantation;Aug2008 Supplement, Vol. 42, pS96 

    Hematopoietic SCT (HSCT) has become a curative therapeutic strategy for several malignant and nonmalignant diseases. We report the comprehensive results of the first 10 years of experience in HSCT from the two major BMT units in Lebanon: Makassed University Hospital and the American University...

  • Prediction of duration and success rate of unrelated hematopoietic stem cell donor searches based on the patient's HLA-DRB1 allele and DRB1-DQB1 haplotype frequencies. Hirv, K.; Bloch, K.; Fischer, M.; Einsiedler, B.; Schrezenmeier, H.; Mytilineos, J. // Bone Marrow Transplantation;Oct2009, Vol. 44 Issue 7, p433 

    Rapid identification of a matched unrelated donor is essential for patients in need of hematopoietic SCT. We carried out a retrospective evaluation of 549 unrelated donor searches (UDSs), which were completed in 2005 for 23 German transplant centers. On the basis of the patient's HLA-DRB1 allele...

  • A cross-sectional study on vision-related quality of life in patients with ocular GvHD. Pezzotta, S; Rossi, G C; Scudeller, L; Antoniazzi, E; Bianchi, P E; Perotti, C; Del Fante, C // Bone Marrow Transplantation;Sep2015, Vol. 50 Issue 9, p1224 

    Ocular GvHD affects about 40-60% of patients receiving bone marrow transplantation. Ocular complaints worsen quality of life (QoL), which, besides survival time, is a primary end point in a patient's follow-up. The aim of our study was to assess the ocular surface status and vision-related QoL...

  • Combination of bone marrow stromal cell transplantation with mobilization by granulocyte-colony stimulating factor promotes functional recovery after spinal cord transection. Jie Luo; Hong-tian Zhang; Xiao-dan Jiang; Shan Xue; Yi-quan Ke // Acta Neurochirurgica;Nov2009, Vol. 151 Issue 11, p1483 

    Spinal cord injury (SCI) results in severe neurological deficit. However, the functional recovery following SCI is very poor due to the neural lost and limited axonal regeneration. To date, there was no effective treatment. Recent studies have shown that bone marrow stromal cells (BMSCs)...

  • Application of Mesenchymal Stromal Cells in Bone Marrow Transplantation for Sensitized Recipients. Xu, Lu-Hong; Fang, Jian-Pei; Hong, Dong-Ling; Wu, Yan-Feng // Acta Haematologica;2012, Vol. 127 Issue 2, p105 

    Sensitized patients are at high risk for graft rejection during transplantation. It is of interest to investigate the effect of mesenchymal stromal cells (MSCs) in sensitized hematopoietic stem cell transplantation. MSCs were generated from bone marrow cells of BALB/c mice. The molecular markers...

  • Neurological Complications after Allogeneic Transplantation – Can We Do Better? Dowling, Mark R.; Ballen, Karen K. // Acta Haematologica;2019, Vol. 142 Issue 4, p193 

    Neurological complications remain a devastating and feared complication after hematopoietic cell transplantation, and a significant source of morbidity and mortality. Significantly, the development of neurologic complications portended a poorer prognosis, with increased non-relapsed mortality,...

  • Transplantation and Other Uses of Human Umbilical Cord Blood and Stem Cells. Goldstein, Gal; Toren, Amos; Nagler, Arnon // Current Pharmaceutical Design;May2007, Vol. 13 Issue 13, p1363 

    Human umbilical cord blood (CB) has established itself as a legitimate source for hematopoeitic stem cell transplantations. Since the first transplantation was preformed in 1988, it is estimated that approximately 4,000 patients, with malignant and non-malignant diseases, were transplanted with...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics