Volchenkov, S. A., Filatova, L. V., Зюзгин, И. С., Ishmatova, I. V., Zverkova, A. A., Motalkina, M. S., Julia A. Nikulina, J. A., Dobrovolskaya , E. V., Elkhova, S. S., Koviazin, A. K., Kramynin, L. A., Kolupaev, N. S., Isimbaeva, A. A., & Semiglazova, T. (2023). The Role of Nutritional Support on the Recovery of Patients with Hodgkin’s Lymphoma during High-Dose Chemotherapy with Autologous Stem Cell Transplantation. Voprosy Onkologii, 69(4), 722–731. https://doi.org/10.37469/0507-3758-2023-69-4-722-731

Abstract

Aim. To evaluate the role of combined nutritional support (NS) in patients with Hodgkin's lymphoma (HL) undergoing high-dose chemotherapy (HDCT) with autologous hematopoietic stem cell transplantation (auto-HSCT).

Materials and methods. The study included 138 patients. The control group consisted of 68 patients with HL who underwent HDCT with auto-HSCT and received NS using supplemental parenteral nutrition (PN). The experimental group included 70 patients who received NS using enteral nutrition (EN) and PN, following an internal NS protocol. The primary endpoints of the study were the engraftment time of the transplant and the hematopoietic recovery time, while the secondary endpoint was the risk of developing mucositis.

Results. The engraftment time of the bone marrow transplant did not show a statistically significant difference between the experimental group (median 10 days [IQR: 9-11]) and the control group (median 10 days [IQR: 9-11]), p = 0,771. Similarly, the hematopoietic recovery time did not differ significantly between the groups: median 12 days (IQR: 11-13) vs. 12 days (IQR: 10-14), p = 0.936. The duration of agranulocytosis also showed no statistical difference between the groups: median 6 days (IQR: 5-8) in the control group versus 7 days (IQR: 6-8) in the experimental group (p = 0.083). However, the median days of granulocyte colony-stimulating factor (g-CSF) therapy in the control group were -13 (IQR: 12-14) days, while in the experimental group — 10 days (IQR: 9-12), with p < 0.001.

The frequency of severe mucositis was higher in the control group compared to the patients in the experimental group (31 vs. 20, respectively, p < 0.05), which resulted in a greater need for nasogastric tube placement (11 cases in the group without NS and 4 cases in the group with NS, p < 0.05).

Conclusion. The study results demonstrated that the addition of combined NS does not affect the transplant engraftment time and the hematopoietic recovery time. However, it does reduce the risk of developing severe mucositis.

https://doi.org/10.37469/0507-3758-2023-69-4-722-731

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