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Published in: Supportive Care in Cancer 2/2021

01-02-2021 | Stem Cell Transplantion | Original Article

Effect of malnutrition-driven nutritional support protocol on clinical outcomes in autologous stem cell transplantation patients

Authors: Heather Lazarow, Ryan Singer, Charlene Compher, Cheryl Gilmar, Colleen R. Kucharczuk, Patricia Mangan, Kelly Salam, Kathleen Cunningham, Edward A. Stadtmauer, Daniel J. Landsburg

Published in: Supportive Care in Cancer | Issue 2/2021

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Abstract

Purpose

Poor nutrition status in patients receiving high-dose chemotherapy and autologous stem cell transplant (ASCT) has been associated with inferior clinical outcomes. We aim to determine whether a malnutrition-driven nutritional support protocol can improve these outcomes.

Methods

In this prospective cohort study, we assessed adults for malnutrition who were consecutively admitted for ASCT between October 2017 and March 2019 (n = 251), and provided enteral or parenteral nutrition (EN/PN) to patients who were malnourished early in the transplantation admission. We compared their clinical outcomes with those of a historical cohort admitted between May 2016 and October 2017 (n = 257) for whom nutrition assessment and initiation of EN/PN were not protocol-driven.

Results

Patients receiving ASCT during the intervention period experienced decreased odds of prolonged hospital stay (p = 0.023), central line–associated bloodstream infection (p = 0.015), mucosal barrier injury (p = 0.037), and high weight loss (p = 0.002), in a multivariate analysis as compared with those receiving ASCT during the control period. Outcomes for ICU transfer, deconditioning on discharge, time to platelet engraftment, and unplanned 30-day hospital readmission did not differ significantly between groups.

Conclusion

A malnutrition-driven nutritional support protocol may improve outcomes for ASCT patients.
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Metadata
Title
Effect of malnutrition-driven nutritional support protocol on clinical outcomes in autologous stem cell transplantation patients
Authors
Heather Lazarow
Ryan Singer
Charlene Compher
Cheryl Gilmar
Colleen R. Kucharczuk
Patricia Mangan
Kelly Salam
Kathleen Cunningham
Edward A. Stadtmauer
Daniel J. Landsburg
Publication date
01-02-2021
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 2/2021
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-020-05571-1

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