Nutritional support practices in hematopoietic stem cell transplantation centers: A nationwide comparison.

Baumgartner, Annic; Bargetzi, Mario; Bargetzi, Annika; Zueger, Noemi; Medinger, Micheal; Passweg, Jakob; Schanz, Urs; Samaras, Panagiotis; Chalandon, Yves; Pichard, Claude; Limonta, Alessandro; Wannesson, Luciano; Pabst, Thomas; Duchosal, Michel A; Hess, Urs; Stanga, Zeno; Mueller, Beat; Schuetz, Philipp (2017). Nutritional support practices in hematopoietic stem cell transplantation centers: A nationwide comparison. Nutrition, 35, pp. 43-50. Elsevier 10.1016/j.nut.2016.10.007

[img] Text
1-s2.0-S0899900716302295-main.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (265kB) | Request a copy

OBJECTIVE

In 2009, international nutritional societies published practice guidelines on screening and nutritional support for patients undergoing stem cell transplantation. Little is known about how these guidelines are implemented in clinical practice. We performed a nationwide survey with the aim of understanding current practice patterns, differences between clinical practice, and international recommendations as well as barriers to the use of nutritional therapy.

METHODS

We performed a qualitative survey including all centers across Switzerland offering allogeneic (n = 3) or autologous (n = 7) stem cell transplantation. We focused on in-house protocols pertaining to malnutrition screening, indications for nutritional support, types of nutritional therapy available and provided, and recommendations regarding neutropenic diets.

RESULTS

All centers offering allogeneic, and most of the centers offering autologous transplantation, had a malnutrition screening tool, mainly the nutritional risk score (NRS 2002) method. Only one center does not provide nutritional support. There is wide variation regarding start and stop of nutritional therapy as well as route of delivery, with five centers recommending parenteral nutrition and five centers recommending enteral nutrition as a first step. Although all centers offering allogeneic transplantation, and approximately every other autologous transplant center, used a neutropenic diet, specific recommendations regarding the type of food and food handling showed significant variation.

CONCLUSION

This Swiss survey found wide variation in the use of nutritional therapy in patients undergoing stem cell transplantation, with low adherence overall to current practice guidelines. Understanding and reducing barriers to guideline implementation in clinical practice may improve clinical outcomes. Close collaboration of centers will facilitate future research needed to improve current practice and ensure high quality of treatment.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology

UniBE Contributor:

Pabst, Thomas and Stanga-Nodari, Zeno

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0899-9007

Publisher:

Elsevier

Language:

English

Submitter:

Nicole Corminboeuf

Date Deposited:

22 Feb 2018 10:50

Last Modified:

25 Sep 2020 13:48

Publisher DOI:

10.1016/j.nut.2016.10.007

PubMed ID:

28241989

Uncontrolled Keywords:

Guidelines Hematopoietic stem cell transplantation Nutrition Survey

BORIS DOI:

10.7892/boris.111231

URI:

https://boris.unibe.ch/id/eprint/111231

Actions (login required)

Edit item Edit item
Provide Feedback