Fuji Shigeo, Cheng Jessica, Yakushijin Kimikazu, Wanitpongpun Chinadol
Department of Hematology, Osaka International Cancer Institute, Osaka, Japan.
Nutrition Support WG, Asia-Pacific Blood and Marrow Transplantation group.
Blood Cell Ther. 2022 Apr 15;5(2):54-60. doi: 10.31547/bct-2021-024. eCollection 2022 May 25.
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an integral part of the treatment strategy for patients with malignant or non-malignant hematological diseases. Clinical outcomes of patients undergoing allo-HSCT have significantly improved in recent decades. However, transplant-related morbidity and mortality remain major issues for allo-HSCT recipients. With regard to nutrition, patients undergoing allo-HSCT are at high risk for malnutrition. It is expected that clinical practice concerning nutritional support in allo-HSCT has been improving in recent decades; however, no data directly support this expectation. One major issue in managing nutritional support during allo-HSCT is the lack of large-scale randomized prospective studies, which leads to a lack of well-established strategies. Accordingly, we need to gather data from studies in non-HSCT and allo-HSCT settings. In some Asia-Pacific countries, a physician's lack of knowledge of nutritional support may impede the application of nutritional support practices recommended by existing guidelines. Another barrier may be the lack of access to an adequately qualified or trained registered dietitian (RD) at allo-HSCT units. Adequate training in the nutritional management of allo-HSCT patients should be provided to all RDs working with HSCT. Herein, we summarize the information on nutritional support in allo-HSCT, focusing on an Asian perspective.
异基因造血干细胞移植（allo-HSCT）是恶性或非恶性血液系统疾病患者治疗策略的重要组成部分。近几十年来，接受allo-HSCT患者的临床结局有了显著改善。然而，移植相关的发病率和死亡率仍然是allo-HSCT受者面临的主要问题。在营养方面，接受allo-HSCT的患者存在营养不良的高风险。预计近几十年来allo-HSCT中营养支持的临床实践一直在改善；然而，尚无数据直接支持这一预期。allo-HSCT期间营养支持管理的一个主要问题是缺乏大规模随机前瞻性研究，这导致缺乏成熟的策略。因此，我们需要收集非HSCT和allo-HSCT环境下研究的数据。在一些亚太国家，医生对营养支持知识的缺乏可能会阻碍现有指南推荐的营养支持实践的应用。另一个障碍可能是allo-HSCT单位缺乏获得足够资质或培训的注册营养师（RD）。应该为所有从事HSCT工作的RD提供allo-HSCT患者营养管理方面的充分培训。在此，我们从亚洲视角总结allo-HSCT中营养支持的相关信息。
