Nutritional Impact of High-Dose Melphalan in Autologous Stem Cell Transplantation

High-dose melphalan is the standard conditioning treatment for patients undergoing autologous hematopoietic stem cell transplantation for hematological malignancies. Although effective, it often causes significant gastrointestinal side effects, such as mucositis, nausea, vomiting, and diarrhea, which can quickly affect patients' nutrition, hydration, and electrolyte balance, leading to acute malnutrition. This nutritional decline increases the risk of infections, prolongs hospital stays, and can worsen short-term recovery. Routine nutritional assessment and early support are not consistently implemented across clinical settings, leading to variability in patient care. This editorial discusses how melphalan-related digestive toxicity affects patients' nutritional status, reviews evidence of its clinical impact, and highlights the importance of regular nutritional monitoring and early intervention. Collaboration among hematologists, dietitians, nurses, and pharmacists, along with standardized nutritional protocols in transplant units, is crucial to help patients tolerate treatment better, recover faster, and improve overall outcomes.