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造血干细胞移植自身免疫性疾病的营养问题:代表欧洲血液与骨髓移植学会自身免疫性疾病工作组及护士组的综述与建议

Nutritional aspects in autoimmune diseases undergoing hematopoietic stem cell transplantation: overview and recommendations on behalf of the EBMT ADWP and Nurses Group.

作者信息

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

机构信息

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.

出版信息

Front Nutr. 2024 May 9;11:1394518. doi: 10.3389/fnut.2024.1394518. eCollection 2024.


DOI:10.3389/fnut.2024.1394518
PMID:38784130
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11111942/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/438d/11111942/ca3f33d3ecf0/fnut-11-1394518-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/438d/11111942/dd0b1302a472/fnut-11-1394518-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/438d/11111942/ca3f33d3ecf0/fnut-11-1394518-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/438d/11111942/dd0b1302a472/fnut-11-1394518-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/438d/11111942/ca3f33d3ecf0/fnut-11-1394518-g002.jpg

相似文献

[1]
Nutritional aspects in autoimmune diseases undergoing hematopoietic stem cell transplantation: overview and recommendations on behalf of the EBMT ADWP and Nurses Group.

Front Nutr. 2024-5-9

[2]
General information for patients and carers considering haematopoietic stem cell transplantation (HSCT) for severe autoimmune diseases (ADs): A position statement from the EBMT Autoimmune Diseases Working Party (ADWP), the EBMT Nurses Group, the EBMT Patient, Family and Donor Committee and the Joint Accreditation Committee of ISCT and EBMT (JACIE).

Bone Marrow Transplant. 2019-1-31

[3]
Hematopoietic stem cell transplantation and cellular therapies for autoimmune diseases: overview and future considerations from the Autoimmune Diseases Working Party (ADWP) of the European Society for Blood and Marrow Transplantation (EBMT).

Bone Marrow Transplant. 2022-7

[4]
The EBMT-ADWP and the CIBMTR.

Handb Clin Neurol. 2024

[5]
Hematopoietic Stem Cell Transplantation for Autoimmune Disease.

Annu Rev Med. 2021-1-27

[6]
Haematopoietic stem cell transplantation for severe autoimmune diseases in children: A review of current literature, registry activity and future directions on behalf of the autoimmune diseases and paediatric diseases working parties of the European Society for Blood and Marrow Transplantation.

Br J Haematol. 2022-7

[7]
Immune Reconstitution After Autologous Hematopoietic Stem Cell Transplantation in Crohn's Disease: Current Status and Future Directions. A Review on Behalf of the EBMT Autoimmune Diseases Working Party and the Autologous Stem Cell Transplantation In Refractory CD-Low Intensity Therapy Evaluation Study Investigators.

Front Immunol. 2018-4-4

[8]
Intestinal Microbiome in Hematopoietic Stem Cell Transplantation For Autoimmune Diseases: Considerations and Perspectives on Behalf of Autoimmune Diseases Working Party (ADWP) of the EBMT.

Front Oncol. 2021-10-22

[9]
French protocol for the diagnosis and management of hematopoietic stem cell transplantation in autoimmune diseases.

Rev Med Interne. 2024-2

[10]
Allogeneic HSCT for Autoimmune Diseases: A Retrospective Study From the EBMT ADWP, IEWP, and PDWP Working Parties.

Front Immunol. 2019-7-4

本文引用的文献

[1]
Nutritional intervention with TGF-beta enriched food for special medical purposes (TGF-FSMP) is associated with a reduction of malnutrition, acute GVHD, pneumonia and may improve overall survival in patients undergoing allogeneic hematopoietic stem transplantation.

Transpl Immunol. 2023-12

[2]
Nonrestrictive diet does not increase infections during post-HSCT neutropenia: data from a multicenter randomized trial.

Blood Adv. 2023-10-10

[3]
The European Society for Blood and Marrow Transplantation (EBMT) roadmap and perspectives to improve nutritional care in patients undergoing hematopoietic stem cell transplantation on behalf of the Cellular Therapy and Immunobiology Working Party (CTIWP) and the Nurses Group (NG) of the EBMT.

Bone Marrow Transplant. 2023-9

[4]
Decrease of lethal infectious complications in the context of causes of death (COD) after hematopoietic cell transplantation: COD-2 and COD-1 study of the Infectious Diseases Working Party EBMT.

Bone Marrow Transplant. 2023-8

[5]
Gut microbiota intervention by pre and probiotics can induce regulatory T cells and reduce the risk of severe acute GVHD following allogeneic hematopoietic stem cell transplantation.

Transpl Immunol. 2023-6

[6]
Nutritional Status of Allogeneic Hematopoietic Stem Cell Transplant Recipients and Post-transplant Outcomes.

Nutr Cancer. 2023

[7]
Levofloxacin prophylaxis and parenteral nutrition have a detrimental effect on intestinal microbial networks in pediatric patients undergoing HSCT.

Commun Biol. 2023-1-13

[8]
Oral Lactoferrin Supplementation during Induction Chemotherapy Promotes Gut Microbiome Eubiosis in Pediatric Patients with Hematologic Malignancies.

Pharmaceutics. 2022-8-16

[9]
The incidence of severe oral mucositis in patients undergoing different conditioning regimens in haematopoietic stem cell transplantation.

Support Care Cancer. 2022-11

[10]
Diet as therapeutic intervention in Crohn's disease.

Prz Gastroenterol. 2022

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