Moody Karen, Finlay Jonathan, Mancuso Carol, Charlson Mary
Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY 10467, USA.
J Pediatr Hematol Oncol. 2006 Mar;28(3):126-33. doi: 10.1097/01.mph.0000210412.33630.fb.
The neutropenic diet is an intervention that excludes certain foods, especially fresh fruits and vegetables, from the diets of pediatric oncology patients to reduce infection rate. The purpose of this study was to demonstrate a safe and feasible methodology to evaluate the infection rate in pediatric cancer patients randomized to the neutropenic diet or to Food and Drug Administration (FDA)-approved food safety guidelines. Pediatric oncology patients receiving myelosuppressive chemotherapy were randomized to the neutropenic diet or to FDA food safety guidelines and followed through one chemotherapy cycle. The primary outcome was febrile neutropenia. Secondary outcomes were adherence and diet tolerability. Nineteen patients were enrolled. Four patients on each diet arm developed febrile neutropenia. The adherence rate was 94% for the neutropenic diet and 100% for the food safety guidelines. Although patients were able to tolerate both diets, there was more reported difficulty adhering to the neutropenic diet. Infection rates for children with cancer on the neutropenic diet were similar to those for patients following food safety guidelines. The results of this study suggest that a larger randomized trial to determine the effectiveness of food safety guidelines in minimizing the risk of food borne infection is safe and feasible in children with cancer.
中性粒细胞减少饮食是一种干预措施，即从儿科肿瘤患者的饮食中排除某些食物，尤其是新鲜水果和蔬菜，以降低感染率。本研究的目的是证明一种安全可行的方法，用于评估随机接受中性粒细胞减少饮食或美国食品药品监督管理局（FDA）批准的食品安全指南的儿科癌症患者的感染率。接受骨髓抑制化疗的儿科肿瘤患者被随机分为接受中性粒细胞减少饮食组或FDA食品安全指南组，并随访一个化疗周期。主要结局是发热性中性粒细胞减少。次要结局是依从性和饮食耐受性。共纳入19例患者。每个饮食组各有4例患者发生发热性中性粒细胞减少。中性粒细胞减少饮食组的依从率为94%，食品安全指南组为100%。尽管患者能够耐受两种饮食，但据报告，坚持中性粒细胞减少饮食的难度更大。接受中性粒细胞减少饮食的癌症儿童的感染率与遵循食品安全指南的患者相似。本研究结果表明，进行一项更大规模的随机试验以确定食品安全指南在降低食源性感染风险方面的有效性，对于癌症儿童来说是安全可行的。
