NUTRITIONAL SUPPORT IN HOSPITALIZED PATIENTS UNDERGOING ALLOGENIC HEMATOPOIETIC STEM CELL TRANSPLANTATION

Abstract

Assessment of the need of parenteral nutrition (PN) for patients undergoing allogeneic Haematopoietic Stem Cell Transplantation (HSCT) and effectiveness of nutritional support. 41 consecutive patients (20 females, 21 males) undergoing allogenic HSCT at the Transplant Center of the AOU Federico II of Naples in the years 2014-2016. Anthropometric parameters, biochemical indices and artificial / parenteral nutrition requirements were evaluated at admission and discharge. Total or supportive PN due to several disease and therapy related complications was indicated for 68.3% of patients (89.3% galenic, 35.7% glutamine enriched, indication reported in table 1). Median duration of nutritional support was 13 days, median timing for start support was 8 days. 87.5% of patients in PN received a TBF conditioning scheme (thiotepa, busulfan, fludarabine), 57.1% immunosuppressive therapy with high-dose cyclophosphamide, 53.6% hematopoietic stem cells from a haploidentical donor (67.9% bone marrow source). Average length of hospitalization, biochemical nutritional and hematological indices and anthropometric parameters observed at discharge are shown in table 2. 42.2% of the patients had home artificial nutrition support (71.5% oral nutritional supplement, 28.5% PN). PN (personalized nutritional intervention) allows patients undergoing allogenic HSCT who have developed more severe complications to achieve a clinical-haematological recovery such as patients without or with minor complications.