Importance of Parenteral Nutrition in Patients Undergoing Hemopoietic Stem Cell Transplantation Procedures in the Autologous System

Abstract

Objective: The aim of this study was to assess the frequency of parenteral nutrition and to compare the impact of parenteral and oral feeding on the nutrition and clinical status of adults undergoing autologous hemopoietic stem cell transplantation. Methods: The study involved 35 patients with neoplasm of the hemopoietic system who underwent hemopoietic cell autotransplantation at the Hematology Clinic (Jagiellonian University, Krakow, Poland). The patients' nutrition status was assessed using body mass index (BMI) values, body mass components, concentration of albumin, and total protein in blood serum. The clinical status evaluation included duration of hematologic reconstruction, concentration of bilirubin, enzyme activity (alanine aminotransferase and aspartate aminotransferase), severity of infections, and duration of hospitalization. Results: Parenteral nutrition was required in 19 patients. Oral feeding was used in 16 patients. Symptoms of malnutrition on the day preceding the introduction of conditioning treatment were recorded only in patients requiring parenteral nutrition (31.6%). In the posttransplantation period, a statistically significant decrease in body mass was observed in both groups, whereas the share of fatty tissue in total body mass was significantly less in patients (men and women) fed parenterally. Conclusion: A supply of 25–30 kcal/kg and 1–1.5 g protein/kg/day as an element of parenteral nutrition (where 20%–30% of the energy requirement was covered by fats, 15%–20% by amino acids, and 50%–55% by glucose) helped prevent the development of malnutrition and restore the functions of the hemopoietic system at a level comparable to that for patients fed naturally.

Parenteral nutrition was started on average 5 days after transplantation, and continued for 9.4 ± 2.8 days. A supply of 25–30 kcal/kg and 1–1.5 g protein/kg/day prevented the development of malnutrition and restored the function of haemopoietic system at a level comparable to that for patients fed orally.

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