Nutritional challenges in children with primary immunodeficiencies undergoing hematopoietic stem cell transplant.

Details

Serval ID
serval:BIB_57E115017528
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Nutritional challenges in children with primary immunodeficiencies undergoing hematopoietic stem cell transplant.
Journal
Clinical nutrition
Author(s)
Zemrani B., Yap J.K., Van Dort B., Evans V., Bartle J., Shandley D., Smart J., Bines J.E., Cole T.
ISSN
1532-1983 (Electronic)
ISSN-L
0261-5614
Publication state
Published
Issued date
09/2020
Peer-reviewed
Oui
Volume
39
Number
9
Pages
2832-2841
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Nutritional profile and management of patients with primary immunodeficiencies (PID) undergoing hematopoietic stem cell transplant (HSCT) has not been described in the literature. We aim to report the nutritional challenges and practices peculiar to this population before and after HSCT and suggest clinical pathways for their management. We conducted a single-centre retrospective study. Inclusion criteria were children aged less than 20 years with a diagnosis of PID who have undergone HSCT at the Royal Children's Hospital Melbourne since April 2014 with a minimal follow-up of 1 year. Nutritional parameters were collected in the pre-transplant period, at conditioning, and at 1, 3, 6 and 12 months post-HSCT. Descriptive analysis were used. Between April 2014 and December 2018, 27 children received 31 HSCT. Before transplant, 33% had a weight and/or height ≤ -2 standard deviations (SD). Forty percent required nutritional support before transplant: 33% had enteral nutrition (EN) while 7% required long-term parenteral nutrition (PN) due to intestinal failure. After transplant, although most children were started on EN, 82% required PN with a mean duration of 67 days. Mean time to full oral diet was 154 days. Pre-transplant mean weight and height were -0.57 SD and -0.88 SD respectively. After a decrease in anthropometric parameters the first 3 months post-transplant, progressive catch up was noticeable for weight (-0.27 SD) with no catch up for height at 1 year (-0.93 SD). Our work highlights the nutritional challenges and specificities of children with PID in the peri-transplant period. An approach to nutrition assessment and management in the pre- and post-transplant period is proposed.
Keywords
Adolescent, Australia, Child, Child, Preschool, Enteral Nutrition/methods, Enteral Nutrition/statistics & numerical data, Female, Hematopoietic Stem Cell Transplantation, Humans, Infant, Male, Nutrition Assessment, Nutritional Status/physiology, Nutritional Support/methods, Nutritional Support/statistics & numerical data, Parenteral Nutrition/methods, Parenteral Nutrition/statistics & numerical data, Postoperative Care, Preoperative Care, Primary Immunodeficiency Diseases/surgery, Retrospective Studies, Treatment Outcome, Children, Nutrition, Primary immunodeficiencies, Transplant
Pubmed
Web of science
Create date
23/01/2020 16:38
Last modification date
20/02/2024 8:17
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