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

Area of Science:

• Hematology
• Nutrition Science
• Transplantation Medicine

Background:

• Published guidelines for nutritional support in hematologic stem cell transplantation (HSCT) exist since 2009.
• Optimal nutritional strategies remain an area requiring further investigation.
• Malnutrition is a significant concern impacting patient outcomes post-HSCT.

Purpose of the Study:

• To conduct an up-to-date literature review on the benefits of nutritional interventions in HSCT.
• To provide evidence-based treatment recommendations for nutritional support in HSCT patients.
• To evaluate the impact of different nutritional strategies on clinical outcomes.

Main Methods:

• Systematic literature search of MEDLINE, EMBASE, and Cochrane Library.
• Inclusion of interventional and observational clinical studies.
• Data extraction and bias assessment for 13 studies (18,167 patients).

Main Results:

• Malnutrition is associated with decreased survival, increased transplant-related mortality, and higher relapse risk.
• Enteral nutrition (EN) demonstrated comparable efficacy to parenteral nutrition (PN) with fewer complications.
• EN was linked to improved survival, reduced acute graft-versus-host disease (GvHD), and faster neutrophil recovery.
• Neutropenic diets did not improve overall survival and were associated with increased infection risk.

Conclusions:

• Current evidence suggests malnutrition adversely affects clinical outcomes in HSCT.
• Enteral nutrition appears superior to parenteral nutrition for HSCT patients.
• Neutropenic diets lack demonstrated benefit and may increase infection risk.
• Further large, randomized controlled trials are necessary to define optimal nutritional support in HSCT.