Enteral nutrition: a first option for nutritional support of children following allo-SCT?

被引:48
作者
Azarnoush, S. [3 ]
Bruno, B. [3 ]
Beghin, L. [4 ,5 ]
Guimber, D. [3 ]
Nelken, B. [3 ]
Yakoub-Agha, I. [6 ]
Seguy, D. [1 ,2 ]
机构
[1] CHRU Lille, Hop Claude Huriez, Serv Nutr, F-59037 Lille, France
[2] Univ Lille Nord France, CHRU, EA2694, Lille, France
[3] Univ Lille Nord France, Hop Jeanne Flandre, Lille, France
[4] INSERM, Unite U995, Inst Med Therapeut & Prevent, F-59045 Lille, France
[5] Univ Lille Nord France, Antenne Pediat Jeanne de Flandre CIC 9301, Ctr Invest Clin, Lille, France
[6] Univ Lille Nord France, Hop Claude Huriez, Serv Malad Sang, Lille, France
关键词
enteral nutrition; SCT; nutritional status; children; BONE-MARROW-TRANSPLANTATION; TOTAL PARENTERAL-NUTRITION; STEM-CELL TRANSPLANTATION; VERSUS-HOST-DISEASE; HEMATOLOGICAL MALIGNANCIES; SIBLING DONOR; RECIPIENTS; GRAFT; COMPLICATIONS; LEUKEMIA;
D O I
10.1038/bmt.2011.248
中图分类号
Q6 [生物物理学];
学科分类号
071011 ;
摘要
Parenteral nutrition (PN) is the treatment of choice for nutritional support of patients undergoing allo-SCT following myeloablative conditioning (MAC). Here we prospectively assessed the outcomes of early enteral nutrition (EN) in a paediatric cohort. From 2003 to 2010, all 65 consecutive children undergoing MAC allo-SCT at our referral centre began EN the day after transplantation. Post-transplant and nutritional outcomes of patients receiving only EN (EN group, n = 50) were compared with those of patients requiring additional PN (EN-PN group, n 15). In the EN group time to platelet recovery (P = 0.01) and length of hospitalisation (P < 0.001) were shorter, while in the EN-PN group the proportion of unrelated donors (P = 0.02) and the frequency of severe acute GVHD (aGVHD; P = 0.004) were higher. All patients were alive at day 100. PN was started 14 days after transplant because of poor digestive tolerance to EN or severe gut aGVHD. The body mass index Z-score in the EN-PN group decreased from transplant to discharge (P = 0.02). In only 23% of cases was PN required for severely ill patients. Our results suggest that EN might be considered to be an option for nutritional support in children undergoing MAC allo-SCT, while PN should be used only as a rescue option, possibly in combination with EN.
引用
收藏
页码:1191 / 1195
页数:5
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