title: Revisiting nutritional support for allogeneic hematologic stem cell transplantation-a systematic review.
abstract: In 2009, the American Society of Parenteral and Enteral Nutrition and its European counterpart (Euopean Society for Parenteral and Enteral Nutrition) published guidelines regarding nutritional support of patients with hematologic stem cell transplantation. Our aim was to do an up-to-date literature review regarding benefit of nutritional interventions and treatment recommendations. We searched MEDLINE, EMBASE and Cochrane Library for interventional and observational clinical studies. We extracted data based on a predefined case report form and assessed bias. Out of 459 potential abstracts, 13 studies of mostly moderate quality with a total of 18 167 patients were included. Two very large trials reported negative associations of malnutrition and survival, transplant-related mortality and relapse risk. Some trials found enteral nutrition (EN) to be as effective as parenteral nutrition (PN) with lower complication rates. In addition, EN was associated with better survival, less acute GvHD and faster neutrophil recovery. A neutropenic diet was not superior regarding overall survival, but in contrast resulted in higher infection risk. Current moderate quality studies show negative associations of malnutrition and clinical outcomes, with EN being superior to PN. There was no benefit of neutropenic diets. Large, randomized controlled studies are needed to better understand optimal nutritional support in this patient population.
authors.affiliation: Aarau and Medical Faculty of the University of Basel, Division of Endocrinology/Metabolism/Clinical Nutrition, Medical University Department, Kantonsspital Aarau, Aarau, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Baumgartner
authors.affiliation: Aarau and Medical Faculty of the University of Basel, Division of Endocrinology/Metabolism/Clinical Nutrition, Medical University Department, Kantonsspital Aarau, Aarau, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Bargetzi
authors.affiliation: Aarau and Medical Faculty of the University of Basel, Division of Endocrinology/Metabolism/Clinical Nutrition, Medical University Department, Kantonsspital Aarau, Aarau, Switzerland.
authors.forename: N
authors.initials: N
authors.lastname: Zueger
authors.affiliation: Division of Oncology/Hematology and Transfusion Medicine, Kantonsspital Aarau, Aarau, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Bargetzi
authors.affiliation: Department of Hematology, University Hospital Basel, Basel, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Medinger
authors.affiliation: Aarau and Medical Faculty of the University of Basel, Division of Endocrinology/Metabolism/Clinical Nutrition, Medical University Department, Kantonsspital Aarau, Aarau, Switzerland.
authors.forename: L
authors.initials: L
authors.lastname: Bounoure
authors.affiliation: Aarau and Medical Faculty of the University of Basel, Division of Endocrinology/Metabolism/Clinical Nutrition, Medical University Department, Kantonsspital Aarau, Aarau, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Gomes
authors.affiliation: Department of Endocrinology, Diabetes and Clinical Nutrition, Bern University Hospital, University of Bern, Switzerland.
authors.forename: Z
authors.initials: Z
authors.lastname: Stanga
authors.affiliation: Aarau and Medical Faculty of the University of Basel, Division of Endocrinology/Metabolism/Clinical Nutrition, Medical University Department, Kantonsspital Aarau, Aarau, Switzerland.
authors.forename: B
authors.initials: B
authors.lastname: Mueller
authors.affiliation: Aarau and Medical Faculty of the University of Basel, Division of Endocrinology/Metabolism/Clinical Nutrition, Medical University Department, Kantonsspital Aarau, Aarau, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Schuetz
mesh_terms: D004750:Enteral Nutrition / Q000592:standards; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D044342:Malnutrition; D018529:Nutritional Support / Q000379:methods / Q000592:standards*; D010288:Parenteral Nutrition / Q000592:standards; D016896:Treatment Outcome