ISSN 1866-8836
Клеточная терапия и трансплантация

N-02. Comparison of low-bacterial and modified diet in HSCT adult patients

Tamara A. Gogoleva                                                

RM Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russia


Contact: Tamara A. Gogoleva, phone: +7 (911) 934-04-15, e-mail: tamaragogoleva@icloud.com

doi 10.18620/ctt-1866-8836-2023-12-3-1-176

Summary

Low-bacterial diet (LBD) has been the standard of care for hematopoietic stem cell (HSC) recipients for over 30 years. Its goal is to reduce the risk of developing infectious complications and acute intestinal graft-versus-host disease (aGvHD). One of the disadvantages of LBD is the risk of developing malnutrition, which creates prerequisites for the alternative diets search. In particular, the use of a modified diet (MD) in clinical practice with fewer restrictions may improve the nutritional and psychological status of patients, but the safety of its use in HSC recipients requires further investigation.

Patients and methods

In the RM Gorbacheva Research Institute of Pediatric Oncology, Hematology and Transplantation from 2019 to 2023, 92 patients with malignancy (acute myeloid and lymphoblastic leukemias (n=65), chronic myeloid leukemias (n=8), aplastic anemia (n=9), myelodysplastic syndrome (n=4), Hodgkin’s lymphoma (n=1) and non-Hodgkin’s lymphoma (n=3), multiple myeloma (n=1) and myelofibrosis (n=1)) who underwent allogeneic HSC transplantation were included to the study. The median age of patients was 36 years (18-65). The patients were divided into two groups depending on the type of diet: LBD (n=63) and MD (n=29). In the study groups the incidence of bacteremia, as well as dysfunction of the gastrointestinal tract due to the development of aGvHD or viral intestinal damage, was assessed. Additionally, the severity of emetic and diarrheal syndromes was assessed. The follow-up period for patients was 100 days after HSCT.

Results

The incidence of diarrheal syndrome was comparable in MD and LDB groups (38% and 46%, p=0.466). At the same time, a severe emetic syndrome was less common in patients adhering to MD (17% and 62%, p<0.001). In the group of patients with LBD, intestinal aGvHD was detected in one case, and in MD group, one case of viral (Human herpes virus 6) enterocolitis was observed. The incidence of bacteremia was comparable in patients with MD and LBD – 52% and 38%, p=0.219.

Conclusions

In this cohort of patients, the use of MD compared with DM did not lead to an increase in the incidence of infectious complications, intestinal aGvHD, and diarrheal syndrome. At the same time, compliance with the MD was accompanied by a lower incidence of emetic syndrome.

Keywords

Hematopoietic stem cell transplantation, modified diet, low-bacterial diet.


Supplement 12-3
09/30/2023

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doi 10.18620/ctt-1866-8836-2023-12-3-1-176

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