Possible clinical outcomes using early enteral nutrition in individuals with allogeneic hematopoietic stem cell transplantation: A single-center retrospective study
Possible clinical outcomes using early enteral nutrition in individuals with allogeneic hematopoietic stem cell transplantation: A single-center retrospective study
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在异基因造血干细胞移植个体中使用早期肠内营养的可能临床结果：单中心回顾性研究
DOI：
10.1016/j.nut.2020.111093
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发表时间：
2021
期刊：
影响因子：
4.4
通讯作者：
Masayoshi Kobune
中科院分区：
文献类型：
--
作者：
Satoshi Iyama;Hiroomi Tatsumi;Tsukasa Shiraishi;Shohei Kikuchi;Tsutomu Sato;Hirofumi Ohnishi;Shin-Ichi Yokota;Masayoshi Kobune
目的异基因造血干细胞移植 (allo-HSCT) 期间的强化营养支持可改善临床结果。然而，早期肠内营养（EN）在异基因造血干细胞移植中的临床意义仍不清楚。这项回顾性研究旨在确定接受异基因造血干细胞移植的个体中早期 EN 的重要性，以及早期营养干预与临床结果（包括肠道微生物组状态）之间的关联。 方法 31 名参与者在调理前接受 EN 治疗。通过粪便样本的meta 16S rRNA基因测序来检查肠道微生物群。结果第60天时中位体重变化仅为-0.35 kg。2年总生存概率为61.1%。治疗相关死亡率的累积发生率为17.4%，急性移植物抗宿主病的累积发生率为32.3%（II-IV级）和3.2%（III-IV级）。在四名参与者中观察到慢性移植物抗宿主病。肠道菌群失调和急性移植物抗宿主病同时发生，且肠球菌种类丰富。结论我们的结果表明，早期营养支持可以改善接受同种异体造血干细胞移植的个体的预后，并可以维持肠道微生物组的稳态。未来需要前瞻性临床试验来阐明 EN 在异基因造血干细胞移植中的作用以及肠道微生物组与 EN 之间的关联。
ObjectivesIntensive nutritional support during allogeneic hematopoietic stem cell transplantation (allo-HSCT) yields improved clinical outcomes. However, the clinical implications of early enteral nutrition (EN) in allo-HSCT remain unclear. This retrospective study was conducted to determine the significance of early EN in individuals who underwent allo-HSCT, and the association between early nutritional intervention and clinical outcomes, including the status of the intestinal microbiome.MethodsThirty-one participants received EN before conditioning. The intestinal microbiota was examined by meta 16S rRNA gene sequencing of fecal samples.ResultsThe median body mass variation was only −0.35 kg on day 60. The probability of 2-y overall survival was 61.1%. The cumulative incidence of treatment-related mortality was 17.4%, and those of acute graft-versus-host disease were 32.3% (grades II–IV) and 3.2% (grades III–IV). Chronic graft-versus-host disease was observed in four participants. Dysbiosis of the intestines and acute graft-versus-host disease occurred simultaneously, andEnterococcusspecies were abundant.ConclusionsOur results suggest that early nutritional support can improve the outcomes for individuals who have undergone allo-HSCT and can maintain homeostasis of their intestinal microbiome. Future prospective clinical trials are required to elucidate the role of EN in allo-HSCT and the association between the intestinal microbiome and EN.