Aoyama Takashi, Yoshitsugu Kanako, Fukaya Masafumi, Kume Tetsuo, Kawashima Miho, Nakajima Kazuko, Arai Hidekazu, Imataki Osamu, Enami Terukazu, Tatara Raine, Ikeda Takashi
Dietary Department, Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan.
Division of Stem Cell Transplantation, Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan.
Med Sci Monit Basic Res. 2019 Sep 10;25:187-198. doi: 10.12659/MSMBR.917329.
This retrospective, historically controlled investigative study examined the benefit of a nutritional support pathway that included nutritional education before the start of conditioning and emphasized oral nutrition in response to nutrition-related adverse events in patients undergoing hematopoietic stem cell transplantation (HSCT).
Participants were patients undergoing allogeneic HSCT; 46 were in the control group (i.e., did not follow our nutritional pathway) and 36 were in the group that underwent nutritional intervention (enhanced nutrition group). We compared the following parameters between groups from the day before the start of conditioning to the day after completion of parenteral nutrition (PN): percent loss of body weight (%LBW), percent loss of skeletal muscle mass (%LSMM), and estimated basal energy expenditure (EBEE) sufficiency rate. The relationship between each parameter and %LBW was also examined. We also compared nutritional indices, gastrointestinal graft versus host disease (GvHD) grade, oral energy intake, and %LBW between groups.
There was a relationship between %LBW, %LSMM, and EBEE sufficiency rate in both groups. Compared with the control group, the enhanced nutrition group had significantly improved energy intake amount, EBEE sufficiency rate, PN duration, and oral energy intake over time. The enhanced nutrition group also had increased oral energy intake, no difference in gastrointestinal GvHD grade, and improved %LBW compared with the control group.
Use of our nutritional support pathway in patients undergoing HSCT may be beneficial for %LBW and gastrointestinal GvHD grade, enabling early enhanced nutritional intervention after HSCT.
这项回顾性、历史对照研究调查了一种营养支持途径的益处，该途径包括在预处理开始前进行营养教育，并强调针对造血干细胞移植（HSCT）患者的营养相关不良事件采用口服营养。
参与者为接受异基因HSCT的患者；46例在对照组（即未遵循我们的营养途径），36例在接受营养干预的组（强化营养组）。我们比较了从预处理开始前一天到肠外营养（PN）完成后一天两组之间的以下参数：体重减轻百分比（%LBW）、骨骼肌质量损失百分比（%LSMM）和估计基础能量消耗（EBEE）充足率。还研究了每个参数与%LBW之间的关系。我们还比较了两组之间的营养指标、胃肠道移植物抗宿主病（GvHD）分级、口服能量摄入量和%LBW。
两组中%LBW、%LSMM和EBEE充足率之间均存在关联。与对照组相比，强化营养组随着时间推移能量摄入量、EBEE充足率、PN持续时间和口服能量摄入量均有显著改善。与对照组相比，强化营养组口服能量摄入量增加，胃肠道GvHD分级无差异，%LBW得到改善。
在接受HSCT的患者中使用我们的营养支持途径可能对%LBW和胃肠道GvHD分级有益，从而能够在HSCT后尽早进行强化营养干预。
