Importance of Parenteral Nutrition in Patients Undergoing Hemopoietic Stem Cell Transplantation Procedures in the Autologous System

• Published in: JPEN. Journal of parenteral and enteral nutrition Vol. 29; no. 4; pp. 241 - 247
• Main Authors: Skop, A., Kolarzyk, Emilia, Skotnicki, A.B.
• Format: Journal Article
• Language: English
• Published: Silver Spring, MD SAGE Publications 01-07-2005; ASPEN; American Society for Parenteral and Enteral Nutrition
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Body Mass Index; Bone marrow, stem cells transplantation. Graft versus host reaction; Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition; Enteral Nutrition; Female; Hematopoietic Stem Cell Transplantation; Humans; Intensive care medicine; Length of Stay; Leukemia - therapy; Lymphoma - therapy; Male; Medical sciences; Nutritional Requirements; Nutritional Status; Parenteral Nutrition - methods; Postoperative Complications - epidemiology; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation, Autologous; Human; Nutrition; Stem cell; Autologous system; Enteral administration; Parenteral administration; Feeding
• ISSN: 0148-6071; 1941-2444
• DOI: 10.1177/0148607105029004241

Objective: The aim of this study was to assess the
frequency of parenteral nutrition and to compare the impact of parenteral and oral
feeding on the nutrition and clinical status of adults undergoing autologous
hemopoietic stem cell transplantation. Methods: The
study involved 35 patients with neoplasm of the hemopoietic system who underwent
hemopoietic cell autotransplantation at the Hematology Clinic (Jagiellonian
University, Krakow, Poland). The patients' nutrition status was assessed using body
mass index (BMI) values, body mass components, concentration of albumin, and total
protein in blood serum. The clinical status evaluation included duration of
hematologic reconstruction, concentration of bilirubin, enzyme activity (alanine
aminotransferase and aspartate aminotransferase), severity of infections, and
duration of hospitalization. Results: Parenteral
nutrition was required in 19 patients. Oral feeding was used in 16 patients. Symptoms
of malnutrition on the day preceding the introduction of conditioning treatment were
recorded only in patients requiring parenteral nutrition (31.6%). In the
posttransplantation period, a statistically significant decrease in body mass was
observed in both groups, whereas the share of fatty tissue in total body mass was
significantly less in patients (men and women) fed parenterally. Conclusion: A supply of 25–30 kcal/kg and 1–1.5 g protein/kg/day as an
element of parenteral nutrition (where 20%–30% of the energy requirement was covered
by fats, 15%–20% by amino acids, and 50%–55% by glucose) helped prevent the
development of malnutrition and restore the functions of the hemopoietic system at a
level comparable to that for patients fed naturally.
Parenteral nutrition was started on average 5 days after transplantation, and
continued for 9.4 ± 2.8 days. A supply of 25–30 kcal/kg and 1–1.5 g protein/kg/day
prevented the development of malnutrition and restored the function of haemopoietic
system at a level comparable to that for patients fed orally.