Song Young-Hwa, Kwon Han-Na, Hong Jeong-Im, Park Juyeon, Kim Ji-Yeon, Kim Hye-Jin
Department of Nutrition, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul 07345, Korea.
Clin Nutr Res. 2020 Oct 29;9(4):332-342. doi: 10.7762/cnr.2020.9.4.332. eCollection 2020 Oct.
Non-Hodgkin lymphoma comprises 2.1% of the total number of cancers in South Korea. Among those, diffuse large B cell lymphoma (DLBCL) comprises the largest percentage. Nutrition interventions have been highlighted because nutritional status in non-Hodgkin's lymphoma patients has a significant impact on treatment and prognosis, but relevant studies are inadequate. Therefore, the aim of this study was to share the case of a nutrition intervention for a patient with primary gastrointestinal non-Hodgkin lymphoma underlying chronic kidney disease who was comorbid with tumor lysis syndrome, which was a complication of a specific chemotherapy. The subject is a 76-year-old patient who was diagnosed with DLBCL. He had abdominal pain, constipation, and anorexia. After chemotherapy, he experienced the tumor lysis syndrome. The patient's condition was continuously monitored, and various nutrition interventions, such as nutrition counseling and education, provision of therapeutic diet, oral nutritional supplement, change of meal plans, and parenteral nutrition support were attempted. As a result of the nutrition intervention, oral intake was increased from 27% of the energy requirement to 70% and from 23% of the protein requirement to 77%. Despite the various nutrition interventions during the hospitalization, there were no improvements in weight and nutrition-related biochemical parameters or malnutrition. However, it was meaningful in that the patient was managed to prevent worsening and the planned third chemotherapy could be performed. These results can be used as the basis for establishing guidelines for nutritional interventions customized to patients under the same conditions.
非霍奇金淋巴瘤占韩国癌症总数的2.1%。其中，弥漫性大B细胞淋巴瘤（DLBCL）占比最大。营养干预受到了关注，因为非霍奇金淋巴瘤患者的营养状况对治疗和预后有重大影响，但相关研究并不充分。因此，本研究的目的是分享一例针对患有慢性肾病的原发性胃肠道非霍奇金淋巴瘤且合并肿瘤溶解综合征（一种特定化疗的并发症）患者的营养干预案例。该患者为一名76岁被诊断为DLBCL的男性。他有腹痛、便秘和厌食症状。化疗后，他出现了肿瘤溶解综合征。对患者的病情进行持续监测，并尝试了各种营养干预措施，如营养咨询与教育、提供治疗性饮食、口服营养补充剂、改变膳食计划以及肠外营养支持。营养干预的结果是，口服摄入量从能量需求的27%增加到70%，从蛋白质需求的23%增加到77%。尽管住院期间进行了各种营养干预，但患者的体重、营养相关生化指标或营养不良状况均无改善。然而，其意义在于成功防止了患者病情恶化，并能够按计划进行第三次化疗。这些结果可作为为相同情况下的患者制定定制化营养干预指南的依据。
