Oral nutritional support to adult patients with acute intestinal Graft Versus Host Disease (GVHD): A proposal for dietary intervention as a model to clinical trials

Chiconato, Geovana Carla; Campos, Denise Johnson; Thomaz, Ana Cláudia; Funke, Vaneuza Araújo Moreira; Vilela, Regina Maria

doi:10.1016/j.clnesp.2020.07.021

Cited by 6 publications

(1 citation statement)

References 19 publications

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“…Though there is a general consensus that nutritional support during allo-HSCT is required, studies have shown that standard clinical practice varies greatly amongst institutions [4], and particularly in those patients who have gastrointestinal GVHD [27]. The use of enteral and parental nutritional support proves to be signi cantly different depending on the age of patient, country of practice and knowledge and availability of nutritional experts [28].…”

Section: Transplant Related Mortality Discussionmentioning

confidence: 99%

Weight loss post-allogeneic stem cell transplant is associated with increased transplant-related mortality

Madsen,

Lee,

Chen

et al. 2023

Support Care Cancer

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Purpose: Allogeneic Stem Cell Transplant (allo-HSCT) patients are at risk of malnutrition and weight loss from impaired oral intake resulting from gastrointestinal toxicities, dysgeusia, and psychological effects.Methods: A retrospective review of 264 adult patients transplanted at Princess Margaret Cancer Centre who achieved relapse-free survival up to 3 months after allo-HSCT was performed.Results: Overall incidence of patients who experienced WL (WL) ≥10% from HSCT to 3 months posttransplant was 45.9% and from HSCT to 6 months was 56.6%. Patients with ≥10% WL from allo-HSCT at 3-months and 6 months had similar 2-year overall survival (OS) compared to those with <10% WL, 55.7% vs. 62.8% (HR=1.38, p=0.11) and 71.1% vs. 77.2% (HR=1.37, P=0.27), respectively. Patients with ≥10% WL 3-and 6-months from allo-HSCT also had similar 2-year relapse-free survival (RFS) compared to those with <10% WL, 48.1% vs. 55.8% (HR=1.26, p=0.22), and 62.7% vs 69.8% (HR=1.29, p=0.31), respectively.The 2-year transplant-related mortality (TRM) was higher for those with ≥10% WL from allo-HSCT to 3months, 35.4% vs. 16.9% (HR=2.39, p=0.0007) and 6 months, 22% vs. 8% (HR=3.1, p=0.0034). Although statistical signi cance was not observed for OS or RFS, patients who experienced ≥10% WL 3-and 6months post allo-HSCT experienced higher 2-year TRM. These results highlight the importance of early intervention and close monitoring of weight post allo-HSCT. Conclusion: Approaches to WL post allo-HSCT should be multifaceted and include members of the interdisciplinary team in order to decrease TRM.

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Section: Transplant Related Mortality Discussionmentioning

confidence: 99%

Weight loss post-allogeneic stem cell transplant is associated with increased transplant-related mortality

Madsen,

Lee,

Chen

et al. 2023

Support Care Cancer

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Recent advances in acute gastrointestinal graft versus host disease (aGvHD): aspects of steroid-resistant disease

Kujawska,

Zeiser,

Gil

2024

Ann Hematol

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Acute Graft versus Host Disease (aGvHD) is a common immunological complication occurring in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). Moreover, aGvHD is associated with a higher risk of infections and metabolic complications, affecting non-relapse mortality. Progress in transplantation has changed the prophylactic and therapeutic strategies of aGvHD and improved patient outcomes. The standard first-line therapy remains steroids, with a response rate of about 50%. The Janus Kinase 2 (JAK2) inhibitor, ruxolitinib, is an effective second-line therapy. The management of patients who developed a disease that is refractory to steroids and ruxolitinib, especially in the severe gastrointestinal forms of aGvHD, is not validated and remains an unmet medical need. In the article, we present the current clinical practice, as well as the latest advances targeting pathophysiological pathways of GvHD and gut microbiota, which may be a potential future of aGvHD therapy.

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Consignes alimentaires pour les patients adultes et pédiatriques en sortie d’hospitalisation post-allogreffe de cellules souches hématopoïétiques (SFGM-TC)

Farrugia,

Lhostette,

Brasseur

et al. 2024

Bulletin du Cancer

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Oral nutritional support to adult patients with acute intestinal Graft Versus Host Disease (GVHD): A proposal for dietary intervention as a model to clinical trials

Cited by 6 publications

References 19 publications

Weight loss post-allogeneic stem cell transplant is associated with increased transplant-related mortality

Weight loss post-allogeneic stem cell transplant is associated with increased transplant-related mortality

Recent advances in acute gastrointestinal graft versus host disease (aGvHD): aspects of steroid-resistant disease

Consignes alimentaires pour les patients adultes et pédiatriques en sortie d’hospitalisation post-allogreffe de cellules souches hématopoïétiques (SFGM-TC)

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