Clin Nutr Res.  2018 Jul;7(3):223-228. 10.7762/cnr.2018.7.3.223.

Nutritional Intervention for a Patient with Acute Lymphoblastic Leukemia on Allogeneic Peripheral Blood Stem Cell Transplantation

• Kim S
• Kim S
• Park Y
• Shin AR
• Yeom H

• KMID: 2417718
• DOI: http://doi.org/10.7762/cnr.2018.7.3.223

Abstract

Hematopoietic stem cell transplantation (HSCT) causes many complications such as anorexia, nausea, vomiting, diarrhea, and mucositis. Most patients undergoing HSCT have risk for malnutrition in the process of transplantation so artificial nutrition support is required. The purpose of this case report is to share our experience of applying nutrition intervention during the transplantation period. According to HSCT process, the change of the patient's gastrointestinal symptoms, oral intake and nutritional status was recorded. By encouraging oral intake and providing parenteral nutrition, the patient had only 0.3%, losing weight during the transplantation period. In conclusion, it emphasized that the nutritional status changes during the HSCT period should be closely monitored and nutritional management through appropriate nutritional support and interventions in hospital and after discharge.

Keyword

Peripheral blood stem cell transplantation; Nutrition support; Acute lymphoblastic leukemia

MeSH Terms

Anorexia
Diarrhea
Hematopoietic Stem Cell Transplantation
Humans
Malnutrition
Mucositis
Nausea
Nutritional Status
Nutritional Support
Parenteral Nutrition
Peripheral Blood Stem Cell Transplantation*
Precursor Cell Lymphoblastic Leukemia-Lymphoma*
Vomiting

Reference

1. PDQ Adult Treatment Editorial Board. PDQ cancer information summaries. Bethesda, MD: National Cancer Institute;2002.

2. Gratwohl A, Baldomero H, Aljurf M, Pasquini MC, Bouzas LF, Yoshimi A, Szer J, Lipton J, Schwendener A, Gratwohl M, Frauendorfer K, Niederwieser D, Horowitz M, Kodera Y. Worldwide Network of Blood and Marrow Transplantation. Hematopoietic stem cell transplantation: a global perspective. JAMA. 2010; 303:1617–1624.

3. Mattsson J, Westin S, Edlund S, Remberger M. Poor oral nutrition after allogeneic stem cell transplantation correlates significantly with severe graft-versus-host disease. Bone Marrow Transplant. 2006; 38:629–633.

4. 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.

5. Dietrich S, Radujkovic A, Stölzel F, Falk CS, Benner A, Schaich M, Bornhäuser M, Ehninger G, Krämer A, Hegenbart U, Ho AD, Dreger P, Luft T. Pretransplant metabolic distress predicts relapse of acute myeloid leukemia after allogeneic stem cell transplantation. Transplantation. 2015; 99:1065–1071.

6. Hadjibabaie M, Iravani M, Taghizadeh M, Ataie-Jafari A, Shamshiri AR, Mousavi SA, Alimoghaddam K, Hosseini S, Ghavamzadeh A. Evaluation of nutritional status in patients undergoing hematopoietic SCT. Bone Marrow Transplant. 2008; 42:469–473.

7. Ward EJ, Henry LM, Friend AJ, Wilkins S, Phillips RS. Nutritional support in children and young people with cancer undergoing chemotherapy. Cochrane Database Syst Rev. 2015; 7:CD003298.

8. So EJ, Lee JS, Kim JY. Nutritional intake and nutritional status by the type of hematopoietic stem cell transplantation. Clin Nutr Res. 2012; 1:3–12.

9. Ottery FD. Patient-generated subjective global assessment. In : McCallum PD, Polisena CG, editors. The clinical guide to oncology nutrition. Chicago, IL: The American Dietetic Association;2000.

10. Bauer J, Capra S, Ferguson M. Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr. 2002; 56:779–785.

11. Isenring EA, Capra S, Bauer JD. Nutrition intervention is beneficial in oncology outpatients receiving radiotherapy to the gastrointestinal or head and neck area. Br J Cancer. 2004; 91:447–452.

12. Dezenhall A, Curry-Bartley K, Blackburn SA, De Lamerens S, Khan AR. Food and nutrition services in bone marrow transplant centers. J Am Diet Assoc. 1987; 87:1351–1353.

13. Deeg HJ, Seidel K, Bruemmer B, Pepe MS, Appelbaum FR, Appelbaum FR. Impact of patient weight on non-relapse mortality after marrow transplantation. Bone Marrow Transplant. 1995; 15:461–468.

14. Schulte C, Reinhardt W, Beelen D, Mann K, Schaefer U. Low T3-syndrome and nutritional status as prognostic factors in patients undergoing bone marrow transplantation. Bone Marrow Transplant. 1998; 22:1171–1178.

15. Rzepecki P, Barzal J, Oborska S. Blood and marrow transplantation and nutritional support. Support Care Cancer. 2010; 18:Suppl 2. S57–S65.

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

17. Martin-Salces M, de Paz R, Canales MA, Mesejo A, Hernandez-Navarro F. Nutritional recommendations in hematopoietic stem cell transplantation. Nutrition. 2008; 24:769–775.

18. August DA, Huhmann MB. American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Board of Directors. A.S.P.E.N. clinical guidelines: nutrition support therapy during adult anticancer treatment and in hematopoietic cell transplantation. JPEN J Parenter Enteral Nutr. 2009; 33:472–500.

19. Bozzetti F, Arends J, Lundholm K, Micklewright A, Zurcher G, Muscaritoli M; ESPEN. ESPEN guidelines on parenteral nutrition: non-surgical oncology. Clin Nutr. 2009; 28:445–454.

20. Davis AD, Whelan KW, Ripley ER, Lodhia SL. The association between nutritional, biochemical and clinical outcomes in allogeneic hematopoietic stem cell transplant patients who received no dietetic intervention, oral nutrition support or enteral nutrition. Bone Marrow Transplant. 2013; 48:Suppl 2. S464.

21. Hung YC, Bauer J, Horsley P, Waterhouse M, Bashford J, Isenring E. Changes in nutritional status, body composition, quality of life, and physical activity levels of cancer patients undergoing autologous peripheral blood stem cell transplantation. Support Care Cancer. 2013; 21:1579–1586.