Department of Medicine, Unit of Endocrinology and Diabetes, Università Campus Bio-Medico di Roma, Rome, Italy; Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain; Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain.
Department of Molecular Medicine, University of Pavia and Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Clin Nutr ESPEN. 2024 Oct;63:400-408. doi: 10.1016/j.clnesp.2024.07.002. Epub 2024 Jul 4.
Patients undergoing allogeneic stem cell transplant (HSCT) have a higher risk of developing malnutrition. The aetiology is multifactorial and complex: the conditioning regimen causes damages to the gastrointestinal tract that can contribute to trigger graft-versus-host disease and/or infectious complications that adversely affect food intake and the gut absorption of nutrients in transplant recipients. Consequently, patients might develop weight loss and muscle wasting. There is mounting evidence that insufficient muscle mass increases the risk of toxicity to many chemotherapy drugs. Furthermore, the screening for malnutrition, assessment and intervention can vary among HSCT centers. Hereby, we report the main nutritional clinical issues in the field of HSCT and the main nutritional tools used in this setting. Future clinical trials investigating nutritional tools and dose-escalating studies based on pre-treatment body composition assessment may help having the potential to alter cancer treatment paradigms.
异体干细胞移植（HSCT）患者发生营养不良的风险较高。其病因是多因素且复杂的：预处理方案可导致胃肠道损伤，从而引发移植物抗宿主病和/或感染性并发症，这些并发症会对患者的食物摄入和肠道营养吸收产生不良影响。因此，患者可能会出现体重减轻和肌肉消耗。越来越多的证据表明，肌肉量不足会增加许多化疗药物毒性的风险。此外，HSCT 中心之间的营养不良筛查、评估和干预措施可能存在差异。在此，我们报告了 HSCT 领域的主要营养临床问题以及该领域中使用的主要营养工具。未来的营养工具临床试验和基于治疗前身体成分评估的剂量递增研究可能具有改变癌症治疗模式的潜力。
