Parenteral nutrition in marrow transplant recipients after discharge from the hospital

The use of parenteral nutrition (PN) following discharge from the hospital and its relation to patient characteristics were evaluated retrospectively in 246 marrow transplant recipients. PN was used in 65% of all patients. Patients with leukemia, regardless of age, sex, type of leukemia, remission status, irradiation schedule, laminar air flow isolation and donor sex match, required more frequent and more prolonged PN than patients with aplastic anemia. Children required PN most often for failure to thrive and adults for stomatitis. There was no significant difference in frequency or duration of PN among 24 patients with acute myelogenous leukemia randomized to receive cyclosporine or methotrexate therapy and among 28 patients with acute lymphoblastic leukemia randomized to interferon or no interferon. We conclude that outpatient PN presents a valuable addition to posttransplant supportive care. It shortens the duration of hospitalization both by earlier discharge of patients still requiring PN and by avoiding readmission to the hospital for the purpose of PN.