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Nutrition in Clinical Practice
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Invited Reviews

Nutrition Support Challenges in Hematopoietic Stem Cell Transplant Patients

Jennifer L. Thompson, RD, LD, CNSD and Jennifer Duffy, RD, LD, CNSD

From the Department of Nutrition, Baylor University Medical Center, Dallas, Texas.

Address correspondence to: Jennifer L. Thompson, RD, LD, CNSD, Baylor University Medical Center, Department of Nutrition, 3500 Gaston Ave, Dallas, TX 75246; e-mail: JenniV{at}baylorhealth.edu.

Hematopoietic stem cell transplant (HSCT) patients can present a number of nutrition challenges despite recent advancements in medical care. Several areas of controversy exist, including whether probiotics can be safely used; the use of probiotics continues to expand but efficacy and safety is a concern in immunocompromised patients, including HSCT recipients. Second, parenteral nutrition continues to be the primary avenue for nutrition support despite growing evidence that enteral feedings can be successfully administered. Last, tight glycemic control has been associated with positive clinical outcomes in hospitalized patients. However, whether tight glycemic control can be achieved and is of benefit in this patient population continues to be debated. This article will discuss the current challenges facing clinicians regarding these 3 issues—probiotics, enteral nutrition support, and glycemic control—and future directions in HSCT.

Key Words: bone marrow transplant • parenteral nutrition • enteral nutrition • probiotics

Nutrition in Clinical Practice, Vol. 23, No. 5, 533-546 (2008)
DOI: 10.1177/0884533608323423
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