Nutritional Support Practices in Hematopoietic Stem Cell Transplantation Centers: A Nationwide Comparison
Presentation Number: SUN 289
Date of Presentation: April 2nd, 2017
Annic Catherine Baumgartner*1 and Philipp Schuetz2
1Kantonsspital Aarau, Switzerland, 2Kantonsspital Aarau, Aarau, Switzerland
Introduction In 2009, international nutritional societies published practice guidelines on screening and nutritional support of patients undergoing stem cell transplantation. Little is known about how these guidelines are implemented in clinical practice. We performed a nationwide survey with the aim of understanding current practice patterns, differences between clinical practice and international recommendations as well as barriers to the use of nutritional therapy.
Methods We performed a qualitative survey including all centers across Switzerland offering allogeneic (n=3) or autologous (n=7) stem cell transplantation. We focused on in-house protocols pertaining to malnutrition screening, indications for nutritional support, types of nutritional therapy available and provided, and recommendations regarding neutropenic diets.
Results All centers offering allogeneic, and most of the centers offering autologous transplantation, had a malnutrition screening-tool, mainly the Nutritional Risk Screening (NRS 2002) tool. Only one center does not provide nutritional support. There is wide variation regarding start and stop of nutritional therapy as well as route of delivery, with 5 centers recommending parenteral nutrition (PN) and 5 centers recommending enteral nutrition (EN) as a first step. Although all centers offering allogeneic transplantation and about every other autologous transplant center used a neutropenic diet, the specific recommendations regarding the type of food and food handling showed significant variation.
Discussion This Swiss survey found wide variation in the use of nutritional therapy in patients undergoing stem cell transplantation, with low adherence overall to current practice guidelines. Understanding and reducing barriers to guideline implementation in clinical practice may improve clinical outcomes. Close collaboration of centers will facilitate future research needed to improve current practice and ensure high quality of treatment.
Disclosure: PS: Principal Investigator, Abbott Laboratories. Nothing to Disclose: ACB