Nutrition support during allogeneic stem cell transplantation: evidence versus practice
Sarah Andersen1,2, Merrilyn Banks3,4, Teresa Brown3,4
1Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, QLD, Australia. sarah.andersen@health.qld.gov.au.
Summary
Nutrition support practices vary widely in allogeneic haematopoietic progenitor cell transplantation (HPCT). Guidelines need updating to optimize enteral nutrition (EN) and parenteral nutrition (PN) for better patient outcomes.
Area of Science:
- Hematology
- Transplantation Medicine
- Clinical Nutrition
Background:
- Enteral nutrition (EN) and parenteral nutrition (PN) are crucial for patients undergoing allogeneic haematopoietic progenitor cell transplantation (HPCT).
- Current practices and consensus on the optimal timing and mode of nutrition support initiation remain limited.
Purpose of the Study:
- To investigate current nutrition support strategies in Australian allogeneic HPCT units.
- To identify barriers and enablers influencing the use of EN and PN in this patient population.
Main Methods:
- A survey and phone interviews were conducted with dietitians from all eligible Australian adult allogeneic HPCT units.
- Data collection focused on current nutrition support protocols and perceived challenges.
Main Results:
- All 12 participating units utilize either EN or PN routinely.
- Half of the units use PN as standard, while the other half use EN routinely.
- Barriers to EN include perceived intolerance and medical team preference for PN; barriers to PN include fluid overload and patient/medical team uncertainty.
Conclusions:
- Significant variation exists in nutrition support delivery for allogeneic HPCT patients.
- Updated clinical guidelines incorporating evidence on EN use and tolerance optimization are needed.
- Standardizing practice through evidence-based nutrition care is essential.
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