Use of various nutritional support regimens in patients with transplanted hematopoietic stem cells

• Main Authors: Maksim Anatol'evich Kucher, Oleg Valer'evich Goloshchapov, Abdulbasir Abdurakhmanovich Ganapiev, Boris Vladimirovich Afanas'ev, M A Kucher, O V Goloshchapov, A A Ganapiyev, B V Afanasyev
• Format: Article
• Language: Russian
• Published: "Consilium Medicum" Publishing house 2010-12-01
• Series: Терапевтический архив
• Subjects: hematopoietic stem cell transplantation; nutritional support; parenteral nutrition; enteral nutrition
• Online Access: https://ter-arkhiv.ru/0040-3660/article/view/30751
• ISSN: 0040-3660; 2309-5342

Aim. To study the impact of modified nutritional support (NS) versus standard NS on therapy tolerability and posttransplantation in patients with oncohematological diseases. Subjects and methods. Fifty-three patients, who had been diagnosed as acute myeloblastic (n = 19) or acute lymphoblastic (n = 16) leukemias, lymphomas (n = 10), and other oncohematological diseases (n = 8) and had received large-dose polychemotherapy followed by hematopoietic stem cell transplantation (HSCT), were prospectively examined. The control group (n = 27) used standard NS (NS was prescribed when gastrointestinal (GI) events occurred; on day 1 after HSCT, the study group (n = 26) had modified NS added by glutamine dipeptide (0.57 g/kg/day). Energy demands were 35 kcal/kg/day; protein requirements were 1.5-1.7 g/kg/day. Artificial nutrition preparations were daily given through infusion pumps for 24 hours. In both groups, the criteria for NS discontinuation were natural assimilation of 60% of the required energy within 3 consecutive days or day 14 after HSCT when GI function was preserved. Results. The patients receiving modified NS showed reductions in the incidence and severity of mucositis (p = 0.05), a less significant decrease in the laboratory and anthropometric indicators of nutritional status (p = 0.01), and a better hospital outcome on day 100 after HSCT (p = 0.01). There were no differences in the rate and severity of acute graft-versus-host reaction (p = 0.7%) and in one-year overall survival (p = 0.7%). Conclusion. As compared with standard NS, modified NS enables a patient to sustain negative consequences of the conditioning regimen, HSCT in the early posttransplantation period.