Nutritional challenges in children with primary immunodeficiencies undergoing hematopoietic stem cell transplant.
Adolescent
Australia
Child
Child, Preschool
Enteral Nutrition
/ methods
Female
Hematopoietic Stem Cell Transplantation
Humans
Infant
Male
Nutrition Assessment
Nutritional Status
/ physiology
Nutritional Support
/ methods
Parenteral Nutrition
/ methods
Postoperative Care
Preoperative Care
Primary Immunodeficiency Diseases
/ surgery
Retrospective Studies
Treatment Outcome
Children
Nutrition
Primary immunodeficiencies
Transplant
Journal
Clinical nutrition (Edinburgh, Scotland)
ISSN: 1532-1983
Titre abrégé: Clin Nutr
Pays: England
ID NLM: 8309603
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
04
09
2019
revised:
08
11
2019
accepted:
10
12
2019
pubmed:
19
1
2020
medline:
7
8
2021
entrez:
19
1
2020
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 31952894
pii: S0261-5614(19)33201-7
doi: 10.1016/j.clnu.2019.12.015
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2832-2841Informations de copyright
Copyright © 2019 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of interest The authors declare no conflicts of interest.