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Generation of Multivirus-specific T Cells to Prevent/treat Viral Infections after Allogeneic Hematopoietic Stem Cell Transplant
Published on: May 27, 2011
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Optimization of nutrition during allogeneic hematologic stem cell transplantation
Current Opinion in Clinical Nutrition and Metabolic Care
|February 22, 2018
Summary
Malnutrition before and during hematopoietic stem cell transplantation (HSCT) is linked to higher mortality. While nutritional support is crucial, its optimal use and the effectiveness of specific diets like the neutropenic diet require further research.
Area of Science:
- Hematology
- Transplantation Medicine
- Clinical Nutrition
Background:
- Malnutrition is a significant independent risk factor for mortality in patients undergoing hematopoietic stem cell transplantation (HSCT).
- The optimal nutritional support strategies to improve outcomes in HSCT patients remain controversial.
- Existing literature highlights the association between malnutrition and poor outcomes, including increased complications and reduced survival.
Purpose of the Study:
- To conduct an up-to-date literature review on nutritional therapy in allogeneic HSCT.
- To evaluate the role of the neutropenic diet in HSCT.
- To assess the use and impact of immunonutrients in HSCT patients.
Main Methods:
- Comprehensive literature search for studies on nutritional therapy in allogeneic HSCT.
- Analysis of observational studies and interventional trials.
- Review of data on different nutritional support routes (enteral vs. parenteral) and specific formulas (immunonutrients).
Main Results:
- Observational studies consistently link malnutrition with adverse outcomes in HSCT.
- Few interventional trials definitively prove the benefits of nutritional therapy over no treatment.
- Enteral nutrition appears associated with fewer complications than parenteral nutrition.
- The benefit of immunonutrition on clinical outcomes is not yet established.
- Strict adherence to neutropenic diets does not reduce infection risk or improve clinical outcomes and is no longer recommended.
Conclusions:
- Malnutrition is a strong negative predictor of outcome in HSCT.
- Optimal nutritional interventions for preventing or treating malnutrition in HSCT patients are not well-defined.
- Larger randomized controlled trials are needed to clarify the role and efficacy of nutritional support in HSCT.
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