Effects of individualized nutrition after allogeneic hematopoietic stem cell transplantation following myeloablative conditioning; a randomized controlled trial
Journal article, Peer reviewed
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OriginalversjonSkaarud KAJ, Hjermstad MJ, Bye A, Veierød MB, Gudmundstuen AM, Lundin KEA, Distante S, Brinch L, Tjønnfjord GE, Iversen PO. Effects of individualized nutrition after allogeneic hematopoietic stem cell transplantation following myeloablative conditioning; a randomized controlled trial. Clinical Nutrition ESPEN. 2018;28:59-66 http://dx.doi.org/10.1016/j.clnesp.2018.08.002
Background & aims: Reduced quality of life (QoL) is prevalent after allogeneic hematopoietic stem cell transplantation (allo-HSCT). In this randomized trial we examined the effect of individualized nutritional support during hospitalization for allo-HSCT. Primary outcome was change in global QoL three months post-HSCT with oral mucositis (OM) and acute graft-versus-host disease (aGVHD) as main secondary outcomes. Methods: Whereas the intervention group received recommended minimum daily intakes of 126 kJ/kg and 0.75 g protein/kg as food, supplements, enteral or parenteral nutrition, the controls received routine feeding. QoL was self-reported using the EORTC QLQ-C30 questionnaire. Results: Between August, 2010 and February, 2016, we randomized 59 and 60 patients to intervention and control, respectively; 40 and 48 being eligible for analysis of QoL. There was no difference between the two groups in mean global QoL after three months (-3.10, 95% 45 CI -11.90-5.69; P=0.49). Nor were there any differences in OM grades 3-4 (RR (vs grades 0-2), 1.11, 95% CI 0.59-2.11 and 0.95, 95% CI 0.72-1.25, respectively; P=0.78), or a GVHD grades 3 or 4 (RR (vs grades 0-2) 0.44, 95% CI 0·12-1.60; and 0.65, 95% CI 0.20-2.20, respectively; P=0.37). Conclusion: Individualized nutritional support with recommended energy and protein intakes during hospitalization had no effect on QoL, OM or aGVHD three months after allo-HSCT compared to routine nutrition.