Enteral nutrition is feasible in pediatric stem cell transplantation patients

Msc, RD Derya Hopanci Bicakli; Yilmaz, Rasih; Aksoylar, Serap; Kantar, Mehmet; Çetingül, Nazan; Kansoy, Savaş

doi:10.1002/pbc.24275

Cited by 27 publications

(28 citation statements)

References 14 publications

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“…On the other hand, PN has been associated with higher risk for infectious and metabolic complications [32,33]. Even though the use of EN seems to be feasible [34][35][36], only 4% of the participating centers in our study use it as first-line intervention for nutritional support. Moreover, 25% of centers use PN prophylactically, even though the prophylactic and routine use of PN has not been recommended [37].…”

Section: Discussionmentioning

confidence: 85%

Variability of nutritional practices in peritransplant period after allogeneic hematopoietic stem cell transplantation: a survey by the Complications and Quality of Life Working Party of the EBMT

Perić

Botti

Stringer

et al. 2018

Bone Marrow Transplant

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Recommendations on screening and nutritional support for patients undergoing hematopoietic stem cell transplantation (HSCT) have been presented by international nutritional societies, but nutritional practices remain poorly standardized. Following the general policy of the European Society for Blood and Marrow Transplantation (EBMT) to standardize transplantation procedures, the Complications and Quality of Life Working Party and Nursing Research Group carried out a survey among all EBMT centers about their current nutritional practices. The aim of this study was to better understand current practices, differences from available guidelines, and possible barriers for recommended nutritional therapy. Responses from 90 centers (19%) from 23 countries were received. We observed a marked variability in nutritional care between EBMT centers and a substantial lack of standardized operating procedures in screening patients for malnutrition and management of gastrointestinal GVHD. Furthermore, our study confirmed neutropenic diet as standard of care in most centers as well a preference for parenteral nutritional support over enteral. On the basis of these findings, future EBMT efforts will focus on better implementation of international nutritional guidelines into clinical practice.

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Section: Discussionmentioning

confidence: 85%

Variability of nutritional practices in peritransplant period after allogeneic hematopoietic stem cell transplantation: a survey by the Complications and Quality of Life Working Party of the EBMT

Perić

Botti

Stringer

et al. 2018

Bone Marrow Transplant

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“…Adherence to nasogastric tube feeding has been demonstrated to be achieved in 50-90% of patients. 27,28,48,50 Especially in children, EN has been shown to be a valuable alternative for PN in most patients. 23,42 Owing to its less invasive nature and the arguments cited above, there is therefore consensus that EN should be preferred over PN, except for cases of gastrointestinal failure or tube-feeding intolerance.…”

Section: Discussionmentioning

confidence: 99%

Revisiting nutritional support for allogeneic hematologic stem cell transplantation—a systematic review

Baumgartner

Bargetzi

Zueger

et al. 2017

Bone Marrow Transplant

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In 2009, the American Society of Parenteral and Enteral Nutrition and its European counterpart (Euopean Society for Parenteral and Enteral Nutrition) published guidelines regarding nutritional support of patients with hematologic stem cell transplantation. Our aim was to do an up-to-date literature review regarding benefit of nutritional interventions and treatment recommendations. We searched MEDLINE, EMBASE and Cochrane Library for interventional and observational clinical studies. We extracted data based on a predefined case report form and assessed bias. Out of 459 potential abstracts, 13 studies of mostly moderate quality with a total of 18 167 patients were included. Two very large trials reported negative associations of malnutrition and survival, transplant-related mortality and relapse risk. Some trials found enteral nutrition (EN) to be as effective as parenteral nutrition (PN) with lower complication rates. In addition, EN was associated with better survival, less acute GvHD and faster neutrophil recovery. A neutropenic diet was not superior regarding overall survival, but in contrast resulted in higher infection risk. Current moderate quality studies show negative associations of malnutrition and clinical outcomes, with EN being superior to PN. There was no benefit of neutropenic diets. Large, randomized controlled studies are needed to better understand optimal nutritional support in this patient population.

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“…Using the gut might be beneficial to maintain its integrity or improve glucose control, which may reduce the risk of GVHD [41,42,44]. Other groups also reported feasibility and promising results of using EN after HSCT [45][46][47]. The major limitation of EN in HSCT is the difficulty of inserting EN tubes in patients with severe mucositis or gastrointestinal tract damage.…”

Section: Nutritional Management During the Early Period After Hsctmentioning

confidence: 92%

Systematic Nutritional Support in Allogeneic Hematopoietic Stem Cell Transplant Recipients

Fuji

Einsele

Savani

et al. 2015

Biology of Blood and Marrow Transplantation

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Allogeneic hematopoietic stem cell transplantation (HSCT) has become an established treatment modality for various hematological diseases. However, in allogeneic HSCT, patients often suffer from severe gastrointestinal complications caused by the conditioning regimen and acute/chronic graft-versus-host disease, which requires support by multidisciplinary nutritional support teams (NST). In addition, pretransplantation nutritional status can affect the clinical outcome after allogeneic HSCT. Therefore, it is important to refer the patient to a NST when becoming aware of nutritional problems before allogeneic HSCT. It is also important to follow nutritional status over the long term, as patients often suffer from various nutritional problems, such as malnutrition and metabolic syndrome, even late after allogeneic HSCT. In summary, NST can contribute to the improvement of nutritional status and possibly prognosis at every stage before and after allogeneic HSCT. Here, we aim to give a comprehensive overview of current understanding about nutritional support in allogeneic HSCT and try to provoke a constructive discussion to stimulate further investigation.

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Enteral nutrition is feasible in pediatric stem cell transplantation patients

Cited by 27 publications

References 14 publications

Variability of nutritional practices in peritransplant period after allogeneic hematopoietic stem cell transplantation: a survey by the Complications and Quality of Life Working Party of the EBMT

Variability of nutritional practices in peritransplant period after allogeneic hematopoietic stem cell transplantation: a survey by the Complications and Quality of Life Working Party of the EBMT

Revisiting nutritional support for allogeneic hematologic stem cell transplantation—a systematic review

Systematic Nutritional Support in Allogeneic Hematopoietic Stem Cell Transplant Recipients

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