Abstract
Background: Correction of metabolic disorders is one of the important point’s supportive care during high-dosechemotherapy with autologous stem cell transplantation (autoHSCT) in patients with Hodgkin’s lymphoma (HL). The impact of nutritional support on recovery during autoHSCT for this group of patients is not clearly understood. To assess the effect of combined nutritional support on the frequency of mucositis, grade of mucositis, number of nasogastric tube in patients group, and frequency of blood transfusions during high-dose chemotherapy with autoHSCT in patients with HL. Aims: The study analyzed 68 patients with Hodgkin’s lymphoma who received high-dose chemotherapy with only parenteral nutritional support (NS) between 2013 and 2016 and 71 patients treated between 2016 and 2020 who received combined NS: combination of parenteral and enteral sipping nutrition. The primary endpoints were the frequency of mucositis, number of nasogastric tube in patients group. Methods: Group of patient without combined NS group received nutritional support using parenteral nutrition in case of a decrease in the level of total protein or albumin, which was assessed by a biochemical blood test. Patients in the combined nutritional support group received combined nutritional support with enteral sips in combination with parenteral nutrition, regardless of total protein and albumin levels. Results: The relative risk (RR) of developing stomatitis in the combined NS group was lower than in the group without combined NS: RR=0.67 (95% CI 0.49-0.92), p=0.015. Enteral nutritional support was associated with a reduced risk of stomatitis when adjusted for age, sex, and BMI: odds ratio (OR)=0.33, 95% CI 0.14-0.78, p=0.012. The RR of developing colitis in the combined NS group was lower: RR=0.58 (95% CI 0.36-0.94), p=0.026. Enteral nutritional support was associated with a reduced risk of colitis after adjusting for age, sex, and baseline BMI: OR=0.38, 95% CI 0.17-0.86, p=0.021. A nasogastric tube was placed statistically less frequently in the combined NS group: 3.0% (n=2) versus 19.6% (n=10), p=0.015. Enteral nutritional support was associated with a reduced frequency of nasogastric tube insertion when adjusted for age, sex, and baseline BMI: OR=0.16, 95%CI 0.03-0.83, p=0.029. In patients with an installed nasogastric tube, the duration of its stay did not statistically significantly differ between groups with and without combined NS: median 6 days (IQD: 4-8) vs. 5 days (IQD: 3-6), respectively (p=0.382). Summary/Conclusion: The data obtained show that combined nutritional support reduces the risk of mucositis, reduces the during frequency of nasogastric tube insertion autoHSCT in patients with Hodgkin’s lymphoma.
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