Modern views of nutritional support in patients undergoing allogeneic stem cell transplantation

Clin Nutr ESPEN. 2024 Oct:63:400-408. doi: 10.1016/j.clnesp.2024.07.002. Epub 2024 Jul 4.

Abstract

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.

Keywords: Enteral nutrition; Gut microbiota; Hematopoietic stem cell transplantation; Nutritional support; Parenteral nutrition.

Publication types

  • Review

MeSH terms

  • Body Composition
  • Graft vs Host Disease
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Malnutrition*
  • Nutrition Assessment
  • Nutritional Status
  • Nutritional Support*
  • Stem Cell Transplantation
  • Transplantation Conditioning
  • Transplantation, Homologous*