• Nutrition · Mar 2021

    Possible clinical outcomes using early enteral nutrition in individuals with allogeneic hematopoietic stem cell transplantation: A single-center retrospective study.

    • Satoshi Iyama, Hiroomi Tatsumi, Tsukasa Shiraishi, Masahiro Yoshida, Ayumi Tatekoshi, Akihito Endo, Taichiro Ishige, Yuh Shiwa, Soushi Ibata, Akari Goto, Kana Nagashima, Hiroto Horiguchi, Chisa Fujita, Hiroshi Ikeda, Kohichi Takada, Takayuki Nobuoka, Yusuke Kamihara, Shohei Kikuchi, Tsutomu Sato, Hirofumi Ohnishi, Yokota Shin-Ichi SI Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan., and Masayoshi Kobune.
    • Department of Hematology, Sapporo Medical University School of Medicine, Sapporo, Japan; Nutritional Support Team, Sapporo Medical University Hospital, Sapporo, Japan. Electronic address: iyama@sapmed.ac.jp.
    • Nutrition. 2021 Mar 1; 83: 111093.

    ObjectivesIntensive nutritional support during allogeneic hematopoietic stem cell transplantation (allo-HSCT) yields improved clinical outcomes. However, the clinical implications of early enteral nutrition (EN) in allo-HSCT remain unclear. This retrospective study was conducted to determine the significance of early EN in individuals who underwent allo-HSCT, and the association between early nutritional intervention and clinical outcomes, including the status of the intestinal microbiome.MethodsThirty-one participants received EN before conditioning. The intestinal microbiota was examined by meta 16S rRNA gene sequencing of fecal samples.ResultsThe median body mass variation was only -0.35 kg on day 60. The probability of 2-y overall survival was 61.1%. The cumulative incidence of treatment-related mortality was 17.4%, and those of acute graft-versus-host disease were 32.3% (grades II-IV) and 3.2% (grades III-IV). Chronic graft-versus-host disease was observed in four participants. Dysbiosis of the intestines and acute graft-versus-host disease occurred simultaneously, and Enterococcus species were abundant.ConclusionsOur results suggest that early nutritional support can improve the outcomes for individuals who have undergone allo-HSCT and can maintain homeostasis of their intestinal microbiome. Future prospective clinical trials are required to elucidate the role of EN in allo-HSCT and the association between the intestinal microbiome and EN.Copyright © 2020 Elsevier Inc. All rights reserved.

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