Gandossi Chiara, Jessop Helen, Hahn Anne, Heininger Lisa, Henes Jörg, Radaelli Alexia Marina, Carmagnola Anna, Morello Enrico, Renica Chiara, Bertulli Alice, Lazzari Lorenzo, Kenyon Michelle, Alexander Tobias, Domenech Ariadna, Greco Raffaella
Hematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy.
Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom.
Front Nutr. 2024 May 9;11:1394518. doi: 10.3389/fnut.2024.1394518. eCollection 2024.
Autoimmune diseases (ADs) represent a heterogeneous group of conditions affecting 5-10% of the global population. In recent decades, hematopoietic stem cell transplant (HSCT), mainly autologous, has been successfully adopted to treat patients affected by severe/refractory ADs. In this context malnutrition has a detrimental impact on relapse, mortality, infection rate, engraftment, long-term survival, and prolongation of hospitalization. However, in this population, the management of nutrition should be improved since nutritional assessment is partially performed in routine clinical practice. A panel of nurses and physicians from the European Society for Blood and Marrow Transplantation (EBMT) reviewed all available evidence based on current literature and expert practices from centers with extensive experience in HSCT for ADs, on the nutritional management of ADs patients during HSCT procedure. In this context, adequate nutritional status predicts a better response to treatment and improves quality of life. Herein, a systematic and comprehensive monitoring of nutritional status before, during and after HSCT, with adequate nutritional support in the case of ADs patients, in addition to assessing the dietary requirements associated with HSCT has been covered. Moreover, given the singularity of each AD, the underlying disease should be considered for an appropriate approach. The management and evaluation of nutritional status must be carried out by a multidisciplinary team to assess the needs, monitor the effectiveness of each intervention, and prevent complications, especially in complex situations as patients affected by ADs.
自身免疫性疾病(ADs)是一组异质性疾病,影响着全球5%-10%的人口。近几十年来,造血干细胞移植(HSCT),主要是自体造血干细胞移植,已成功用于治疗重症/难治性ADs患者。在这种情况下,营养不良会对复发、死亡率、感染率、植入、长期生存以及住院时间延长产生不利影响。然而,在这一人群中,营养管理仍需改进,因为常规临床实践中营养评估仅部分进行。欧洲血液和骨髓移植学会(EBMT)的一组护士和医生根据现有文献以及在ADs的HSCT方面经验丰富的中心的专家实践,对ADs患者在HSCT过程中的营养管理的所有可用证据进行了审查。在这种情况下,充足的营养状况预示着对治疗有更好的反应,并能改善生活质量。本文涵盖了在HSCT前、中、后对营养状况进行系统全面的监测,在ADs患者中给予充足的营养支持,此外还评估了与HSCT相关的饮食需求。此外,鉴于每种AD的独特性,应考虑基础疾病以采取适当的方法。营养状况的管理和评估必须由多学科团队进行,以评估需求、监测每次干预的效果并预防并发症,尤其是在ADs患者这种复杂情况下。
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