Revisiting nutritional support for allogeneic hematologic stem cell transplantation-a systematic review.

Baumgartner, A; Bargetzi, A; Zueger, N; Bargetzi, M; Medinger, M; Bounoure, L; Gomes, F; Stanga, Z; Mueller, B; Schuetz, P (2017). Revisiting nutritional support for allogeneic hematologic stem cell transplantation-a systematic review. Bone marrow transplantation, 52(4), pp. 506-513. Nature Publishing Group 10.1038/bmt.2016.310

Text bmt2016310.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (162kB)

In 2009, the American Society of Parenteral and Enteral Nutrition and its European counterpart (Euopean Society for Parenteral and Enteral Nutrition) published guidelines regarding nutritional support of patients with hematologic stem cell transplantation. Our aim was to do an up-to-date literature review regarding benefit of nutritional interventions and treatment recommendations. We searched MEDLINE, EMBASE and Cochrane Library for interventional and observational clinical studies. We extracted data based on a predefined case report form and assessed bias. Out of 459 potential abstracts, 13 studies of mostly moderate quality with a total of 18 167 patients were included. Two very large trials reported negative associations of malnutrition and survival, transplant-related mortality and relapse risk. Some trials found enteral nutrition (EN) to be as effective as parenteral nutrition (PN) with lower complication rates. In addition, EN was associated with better survival, less acute GvHD and faster neutrophil recovery. A neutropenic diet was not superior regarding overall survival, but in contrast resulted in higher infection risk. Current moderate quality studies show negative associations of malnutrition and clinical outcomes, with EN being superior to PN. There was no benefit of neutropenic diets. Large, randomized controlled studies are needed to better understand optimal nutritional support in this patient population.

Interest & Impact

Downloads

2 since deposited on 19 Feb 2018
0 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item