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Autografting

Clinical effect of individualized parenteral nutrition vs conventional method in patients undergoing autologous hematopoietic SCT

Bone Marrow Transplantation volume 48, pages 958–962 (2013)Cite this article

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Abstract

Malnutrition in patients undergoing hematopoietic SCT is known as a risk factor for adverse effects and is directly or indirectly responsible for excess mortality and morbidity. We designed the present study to evaluate the effects of individualized parenteral nutrition (PN) and compare the present method to the conventional PN. Individualized PN based on the Harris−Benedict equation was administered to 30 patients after hematopoietic SCT and was compared with an age, gender and disease matched group of patients who underwent hematopoietic SCT with conventional PN. These two groups were compared on clinical, hematological, nutritional outcomes. Comparing duration of hospital stay (P value<0.0001), infection (P value=0.01), time to platelet engraftment (P value=0.02), units of packed cell transfusion (P value=0.006) and decrease in body weight (P value=0.004) showed significant differences between the two groups. In conclusion, the use of individualized PN seems more beneficial than conventional PN.

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References

  1. Muscaritoli M, Conversano L, Torelli G, Arcese W, Capria S, Cangiano C et al. Clinical and metabolic effect of different parenteral nutrition regimens in patients undergoing allogenic hematopoietic stem cell transplantation. Transplantation 1998; 66: 610–616.

    Article  CAS  Google Scholar 

  2. Cetin T, Arpaci F, Dere Y . Total parenteral nutrition delays platelet engraftment in patients who undergo autologous hematopoietic stem cell transplantation. Nutrition 2002; 18: 599–603.

    Article  CAS  Google Scholar 

  3. Nitenberg G, Raynard B . Nutritional support of the cancer patient: Issues and dilemmas. Crit Rev Oncol/ Hematol 2000; 34: 137–168.

    Article  CAS  Google Scholar 

  4. Iestra JA, Fibbe WE, Zwinderman AH, van Staveren WA, Kromhout D . Body weight recovery, eating difficulties and compliance with dietary advice in the first year after stem cell transplantation: A prospective study. Hematopoietic stem cell transplantation 2002; 29: 417–424.

    CAS  Google Scholar 

  5. Rzepecki P, Barzal J, Sarosiek T, Szczylik C . Biochemical indices for the assessment of nutritional status during hematopoietic stem cell transplantation: Are they worth using? A single center experience. Hematopoietic stem cell transplantation 2007; 40: 567–572.

    CAS  Google Scholar 

  6. Muscaritoli M, Grieco G, Capria S, Maurizio, Paola Iori A, Fanelli FR . Nutritional and metabolic support in patients und ergoing hematopoietic stem cell transplantation. Am J Clin Nutr 2002; 75: 183–190.

    Article  CAS  Google Scholar 

  7. Donini LM, Savina C, Ricciardi LM, Coletti C, Paolini M, Scavone L et al. Predicting the outcome of artificial nutrition by clinical and functional indices. Nutrition 2009; 25: 11–19.

    Article  Google Scholar 

  8. Eagle DA, Gian V, Lauwers GY, Manivel JC, Moreb JS, Mastin S et al. Post-transplant complications: gastro paresis following hematopoietic stem cell transplantation. Bone Marrow Transplant 2001; 28: 59–62.

    Article  CAS  Google Scholar 

  9. Arfons LM, Lazarus HM . Total parenteral nutrition and hematopoietic stem cell transplantation: an expensive placebo? Hematopoietic stem cell transplantation 2005; 36: 281–288.

    CAS  Google Scholar 

  10. Szeluga DJ, Stuart RK, Brookmeyer R, Utermohlen V, Santos GW . Nutritional support of bone marrow transplant recipients: A prospective, randomized clinical trial comparing total parenteral nutrition to an enteral feeding program. Cancer Res 1987; 47: 3309–3316.

    CAS  PubMed  Google Scholar 

  11. Hwang TS, Chiang CR, Wang PN . Parenteral nutrition support after bone marrow transplantation: comparison of total and partial parenteral nutrition during the early post transplantation period. Nutrition 2001; 17: 773–775.

    Article  CAS  Google Scholar 

  12. Taveroff A, McArdle AH, Rybka WB . Reducing parenteral energy and protein intake improvesmetabolic homeostasis after hematopoietic stem cell transplantation. Am J Clin Nutr 1991; 54: 1087–1092.

    Article  CAS  Google Scholar 

  13. Lough M, Watkinst R, Campbell M, Carr K, Burnett A, Shenkin A et al. Parenteral nutrition in hematopoietic stem cell transplantation. Clin Nutr 1990; 9: 97–101.

    Article  CAS  Google Scholar 

  14. Bozzetti F . Basics in clinical nutrition: nutritional support in cancer. e-SPEN, Eur e-J Clin Nutr Metab 2010; 5: e148–e152.

    Article  Google Scholar 

  15. Horsley P, Bauer J, Gallagher B . Poor nutritional status prior to peripheral blood stem cell transplantation is associated with increased length of hospital stay. Bone Marrow Transplant 2005; 35: 1113–1116.

    Article  CAS  Google Scholar 

  16. Roberts S, Miller J, Pineiro L, Jennings L . Total parenteral nutrition vs oral diet in autologous hematopoietic cell transplant recipients. Hematopoietic stem cell transplantation 2003; 32: 715–721.

    CAS  Google Scholar 

  17. Sheean PM, Braunschweig C, Rich E . The incidence of hyperglycemia in hematopoietic stem cell transplant recipients receiving total parenteral nutrition: a pilot study. J Am Diet Assoc 2004; 104: 1352–1360.

    Article  Google Scholar 

  18. Jeejeebhoy KN . Enteral and parenteral nutrition: evidence based approach. Proc Nutr Soc 2001; 60: 399–402.

    Article  CAS  Google Scholar 

  19. Dissanaike S, Shelton M, Warner K, O'Keefe GE . The risk for blood stream infections is associated with increased parenteral caloric intake in patients receiving parenteral nutrition. Crit Care 2007; 11: R114 (Available from http://ccforum.com/content/11/5/R114 Accessed October 24, 2007; published online 24 October 2007; doi:10.1186/cc6167).

    Article  PubMed  PubMed Central  Google Scholar 

  20. Lenssen P, Bruemmer BA, Bowden RA, Gooley T, Aker SN, Mattson D . Intravenous lipid dose and incidence of bacteremia and fungemia in patients undergoing bone marrow transplantation. Am J Clin Nutr 1998; 67: 927–933.

    Article  CAS  Google Scholar 

  21. Lenssen P, Cheney CL, Aker SN, Cunningham BA, Darbinian J, Gauvreau JM et al. Intravenous branched chain amino acid trial in marrow transplant recipients. JPEN J Parenter Enteral Nutr 1987; l1: 112–118.

    Article  Google Scholar 

  22. Weisdorf S, Holland C, Sharp HL, Teasley K, Schissel K, McGlave PB et al. Total parenteral nutrition in hematopoietic stem cell transplantation: a clinical evaluation. J Pediatr Gustro enterol Nutr 1984; 3: 95–100.

    Article  CAS  Google Scholar 

  23. Mulder P, Bouman J, Gietima J, Van Rijsbergen H, Mulder NH, Van der Geest S et al. Hyperalimentation in autologous hematopoietic stem cell transplantation for solid tumors. Cancer 1989; 64: 2045–2052.

    Article  CAS  Google Scholar 

  24. Fleck A, Raines G, Hawker F, Trotter J, Wallace PI, Ledingham IM et al. Increased vascular permeability: a major cause of hypoalbuminaemia in disease and injury. Lancet 1985; 1: 781–784.

    Article  CAS  Google Scholar 

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Acknowledgements

The authors would like to thank the Shahid Beheshti school of pharmacy for their support of this research, which was a part of the general pharmacy research thesis.We also thank Soheila Abedinpour, Zeinab Kaboli, Farideh Balazadeh and other members of our nursing team in Taleghani hematopoietic SCT center for helping us to perform this study.

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Authors and Affiliations

  1. Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of medical sciences, Tehran, Iran

    M Tavakoli-Ardakani

  2. Pharmaceutical Sciences Research Center, Shahid Beheshti University of medical sciences, Tehran, Iran

    M Tavakoli-Ardakani

  3. Students Research Committee, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    B Neman

  4. Department of hematology and oncology, School of Pharmacy, Shahid Beheshti University of medical sciences, Tehran, Iran

    M Mehdizadeh

  5. Department of hematology School of Pharmacy, Shahid Beheshti university of medical sciences, Tehran, Iran

    A Hajifathali

  6. Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of medical sciences, Tehran, Iran

    J Salamzadeh

  7. Department of hematology and oncology, School of Pharmacy, Shahid Beheshti University of medical sciences, Tehran, Iran

    M Tabarraee

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  1. M Tavakoli-Ardakani
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  2. B Neman
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Correspondence to M Mehdizadeh.

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Tavakoli-Ardakani, M., Neman, B., Mehdizadeh, M. et al. Clinical effect of individualized parenteral nutrition vs conventional method in patients undergoing autologous hematopoietic SCT. Bone Marrow Transplant 48, 958–962 (2013). https://doi.org/10.1038/bmt.2012.280

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  • DOI: https://doi.org/10.1038/bmt.2012.280

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