Related Experiment Video
Updated: Aug 2, 2025
Induction of Intestinal Graft-versus-host Disease and Its Mini-endoscopic Assessment in Live Mice
Published on: February 11, 2019
A retrospective case-control study of gastrostomy use in children undergoing hematopoietic cell transplantation
Karin Mellgren1,2, Tom Nicolajsen3, Tania Panagiota Christoforaki4
1Department of Pediatric Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Insights
Gastrostomy feeding in pediatric hematopoietic cell transplantation (HCT) is safe and helps maintain nutritional status. Children receiving gastrostomy had better weight outcomes post-HCT without impacting survival or graft-versus-host disease.
Area of Science:
- Pediatric Hematology
- Transplantation Medicine
- Clinical Nutrition
Background:
- Maintaining optimal nutritional status is crucial but challenging for pediatric patients undergoing hematopoietic cell transplantation (HCT).
- Nutritional support strategies require careful consideration to balance benefits and potential risks during this intensive procedure.
Purpose of the Study:
- To compare the nutritional status and HCT-related outcomes of pediatric patients who received a gastrostomy (GS) before HCT versus those who did not (NGS).
- To evaluate the safety and efficacy of gastrostomy as a nutritional intervention in pediatric HCT.
Main Methods:
- A multicentric retrospective study involving 227 pediatric patients undergoing HCT between 2005 and 2015.
- Patients were divided into two groups: 112 received a gastrostomy (GS group) and 115 did not (NGS group).
- Nutritional status and HCT parameters were assessed at the time of HCT and at 3, 6, and 12 months post-HCT.
Main Results:
- Patients in the GS group had a significantly higher weight Standard Deviation Score (SDS) at HCT (0.71 vs. 0.17, p=0.01).
- The NGS group experienced greater weight loss in the first 3 months post-HCT, while the GS group showed slight weight increase at 12 months.
- No significant differences were observed in acute graft-versus-host disease (GvHD), overall survival, or non-relapse mortality between the groups. However, the GS group had more febrile episodes requiring IV antibiotics (p<0.001).
Conclusions:
- Gastrostomy feeding is a safe method for maintaining nutritional status in pediatric HCT patients.
- The use of gastrostomy does not negatively impact survival outcomes in this population.
- Gastrostomy can be a valuable tool to support nutritional well-being during and after HCT in children.
Background:
Maintaining a good nutritional status during the hematopoietic cell transplantation (HCT) procedure is challenging in the pediatric population.
Methods:
In a multicentric retrospective study, we compared the outcome of nutritional status and HCT-related parameters in 227 pediatric patients during and after HCT between 2005 and 2015. 112 patients received a gastrostomy before the start of HCT (GS group), and 115 did not receive a gastrostomy (NGS). Data collection was performed at HCT, 3, 6, and 12 months post-HCT.
Results:
At time point of HCT the Standard Deviation Score (SDS) of weight was 0.17 in the NGS group, and 0.71 in the GS group (p = .01) Patients in the NGS group lost more weight during the first 3 months after HCT than patients in the GS group. At 12 months, patients in the NGS remained at a lower weight, while patients in the GS group slightly increased their weight. There were no differences between the groups in the incidence of acute graft-versus-host-disease (GvHD), overall survival, and non-relapse mortality. However, the number of febrile episodes requiring intravenous treatment with antibiotics, was higher in the GS group as compared to the NGS group, during the first 3 months post-HCT (p < .001).
Conclusions:
Our results indicate that gastrostomy can be utilized in children undergoing HCT without any negative effects on mortality. Therefore, the use of a gastrostomy appears to be a safe option to maintain a good nutritional status during the HCT procedure.
