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

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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.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition

UniBE Contributor:

Stanga-Nodari, Zeno

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0268-3369

Publisher:

Nature Publishing Group

Language:

English

Submitter:

Andreas Melmer

Date Deposited:

19 Feb 2018 15:21

Last Modified:

25 Sep 2020 13:54

Publisher DOI:

10.1038/bmt.2016.310

PubMed ID:

28067888

BORIS DOI:

10.7892/boris.111474

URI:

https://boris.unibe.ch/id/eprint/111474

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