Modern aspects of nutritional support during hematopoietic stem cell transplantation: review, experience of the N.N. Petrov National Medical Research Center of Oncology


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Abstract

A review of the literature and analysis effect of nutritional support on the development of nutritional deficiency in oncohematological patients who underwent hematopoietic stem cell transplantation (HSCT) are presented. Stem cell transplantation is associated with a high risk of nutritional deficiencies. Nutritional support (NS) is indicated for patients who underwent alloHSCT and autoHSCT in order to reduce the incidence of infectious complications and reduce the risk of nutritional deficiency. Currently, there are recommendations for NP with alloHSCT, while there are no recommendations for patients with autoHSCT. The experience of providing nutritional support in the Department of Hematology of N.N. Petrov National Medical Research Center of Oncology was analyzed. The study included 138 patients. The control groups included 68 patients with Hodgkin’s lymphoma (HL) who underwent high-dose chemotherapy (HDCT) with autologous stem cell transplantation (autoHSCT), who received nutritional support using additional parenteral nutrition (PN) in case of a decrease in total protein (TP). The experimental group included 70 patients who received nutritional support using enteral nutrition and PN according to the internal NS protocol. After HDCT and autoHSCT in the control group, 48 patients had hypoproteinemia (70%), in the group with combined NS in 21 patients (30%), p<0.001. The median decrease in the level of total protein in the group without NS was 16%, in the group with combined NS 10%, at p=0.005. When comparing the patient’s nutritional status before and after HSCT with autoHSCT, it turned out that the frequency of malnutrition in the control group was statistically significantly higher than in the experimental group: 34% vs. 15%, respectively (p<0.01). The results of the study showed that the addition of standardized nutritional support using EN and PN reduces the risks of developing nutritional deficiencies in patients with HL during HDCT with autoHSCT. The features of NP during HSCT are still not well understood. Review of NP studies during HSCT from 2009 to 2019 confirms the need for further research to optimize NP protocols and its impact on survival.

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About the authors

S. A Volchenkov

N.N. Petrov National Medical Research Center of Oncology

St. Petersburg, Russia

Larisa V. Filatova

N.N. Petrov National Medical Research Center of Oncology; North-Western State Medical University n.a. I.I. Mechnikov

Email: larisa_filatova@list.ru
Dr. Sci. (Med.), Associate Professor, Leading Researcher at the Department of Innovative Methods of Therapeutic Oncology and Rehabilitation; Professor at the Department of Oncology St. Petersburg, Russia; St. Petersburg, Russia

S. V Lyubimov

N.N. Petrov National Medical Research Center of Oncology

St. Petersburg, Russia

I. S Zyuzgin

N.N. Petrov National Medical Research Center of Oncology

St. Petersburg, Russia

S. S Elkhova

N.N. Petrov National Medical Research Center of Oncology

St. Petersburg, Russia

A. A Zverkova

N.N. Petrov National Medical Research Center of Oncology

St. Petersburg, Russia

I. V Ishmatova

N.N. Petrov National Medical Research Center of Oncology

St. Petersburg, Russia

T. Yu Semiglazova

N.N. Petrov National Medical Research Center of Oncology; North-Western State Medical University n.a. I.I. Mechnikov

St. Petersburg, Russia; St. Petersburg, Russia

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