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Total parenteral nutrition and nutritional assessment and leukaemic children undergoing bone marrow transplantation
Insights
Total parenteral nutrition (TPN) effectively supports children with leukaemia during bone marrow transplantation (BMT). Prealbumin and retinol-binding protein are sensitive indicators of nutritional recovery in these critical patients.
Area of Science:
- Pediatric Oncology
- Clinical Nutrition
- Hematology
Background:
- Children with leukaemia undergoing bone marrow transplantation (BMT) experience severe catabolic states due to aggressive conditioning regimens.
- Total parenteral nutrition (TPN) is essential for managing these pediatric patients during BMT.
Purpose of the Study:
- To assess the efficacy of TPN in children with leukaemia undergoing BMT.
- To evaluate anthropometric and biochemical markers for monitoring nutritional status post-BMT.
Main Methods:
- Study included 25 children with leukaemia undergoing BMT.
- Nutritional status was monitored using anthropometric parameters and biochemical variables (albumin, retinol-binding protein, prealbumin).
Main Results:
- TPN-related complications were primarily metabolic, mild, and manageable.
- No infections were linked to the hyperalimentation solution or infusion lines.
- Prealbumin and retinol-binding protein demonstrated statistically significant positive variations, indicating sensitivity to nutritional repletion.
Conclusions:
- TPN is effective in preventing expected marked variations in anthropometric parameters and albumin in pediatric BMT patients.
- Prealbumin and retinol-binding protein are sensitive and reliable biomarkers for assessing nutritional response to TPN post-BMT.
Abstract:
The aggressive radiotherapy and chemotherapy used in conditioning regimens for children with leukaemia undergoing bone marrow transplantation (BMT) cause a severe catabolic state. Total parenteral nutrition (TPN) is indispensable in the management of these patients. 25 children with leukaemia undergoing BMT were studied to evaluate the efficacy of TPN and the value of anthropometric parameters and biochemical variables (albumin, retinol-binding protein and prealbumin) in monitoring nutritional status in the critical post-BMT phase. The complications of TPN were mainly metabolic, generally mild and easily controlled. The hyperalimentation solution and infusion line were not responsible for infection in any patient. The marked variations in anthropometric parameters and albumin expected in such patients were not observed in our children due to the nutritional support given. Prealbumin and retinol-binding protein showed statistically significant, positive variations (P less than 0.01), thus proving sensitive indices of the response to nutritional repletion.