Roberts Susan, Thompson Jennifer
Baylor University Medical Center Nutrition Services, 3500 Gaston Avenue, Dallas, Texas 75246, USA.
Nutr Clin Pract. 2005 Aug;20(4):440-50. doi: 10.1177/0115426505020004440.
Graft-vs-host disease (GVHD) is a major complication after allogeneic hematopoietic stem cell transplantation. Both acute and chronic forms of GVHD are challenging to manage medically and nutritionally. Patients with advanced GVHD commonly become depleted nutritionally, with loss of lean body mass (LBM) and functional status. We present 2 case reports of patients who developed GVHD and subsequent nutrition decline. Although both patients were candidates for specialized nutrition support (SNS), only 1 was able to receive enteral and parenteral nutrition due to GVHD complications preventing access for provision of SNS. Fortunately, the patients have remained in remission from their hematologic malignancy, but they continue to cope with chronic GVHD and its consequences. These cases exhibit the complexity of managing a patient with extensive GVHD and nutrition interventions for clinicians to consider to optimize outcomes.
移植物抗宿主病（GVHD）是异基因造血干细胞移植后的主要并发症。急性和慢性GVHD在医学和营养管理方面都具有挑战性。晚期GVHD患者通常会出现营养耗竭，伴有瘦体重（LBM）和功能状态下降。我们报告2例发生GVHD并随后出现营养状况恶化的患者。尽管两名患者均符合接受特殊营养支持（SNS）的条件，但由于GVHD并发症导致无法进行SNS，只有1例患者能够接受肠内和肠外营养。幸运的是，这些患者的血液系统恶性肿瘤已处于缓解期，但他们仍在应对慢性GVHD及其后果。这些病例展示了管理广泛GVHD患者及营养干预的复杂性，以供临床医生考虑以优化治疗结果。
