OPTIMISING NUTRITION DELIVERY DURING HAPLOID IDENTICAL STEM CELL TRANSPLANT

ANUSUYA HEMA PRABHAKAR; VINITHA KRISHANAN; ARUNA RAJENDRAN; Shrishu Kamath; Manimegalai MANIMEGALI

doi:10.36948/ijfmr.2025.v07i04.52184

OPTIMISING NUTRITION DELIVERY DURING HAPLOID IDENTICAL STEM CELL TRANSPLANT

Author(s)	Ms. ANUSUYA HEMA PRABHAKAR, Dr. VINITHA KRISHANAN, Dr. ARUNA RAJENDRAN, Dr. Shrishu Kamath, Dr. Manimegalai MANIMEGALI
Country	India
Abstract	HSCT, belong to a high‐risk group of patients who experience nutritional problems before, during and after the transplantation period(Arends et al., 2017).Specialized nutrition support minimizes the nutritional consequences and complications resulting from the procedure. A17yr old male with relapsed ALL ,height 174 cm , weight 55 kg presented with 10kg weight loss in a month, moderate oral intake and excessive fatigue.His BMI was 17kg/m2 and PGSGA score -7 (mild malnutrition). Patient was anaemic and had low counts. Energy requirement was calculated using Schofield Equation -1595 kcals, protein 80g at 1.5g/BW. During conditioning therapy,due to poor oral intake,high protein ONS suggested along with neutropenic high protein diet. From -D1 to -D8 an average of 55% calorie and 40% protein met. A further 3% weight loss and muscle loss noted. On D0 of stem cell transfusion patient was NPO.On+D1to+D5 due to poor oral intake RTF@100ml 3rd hourly with trial oral was initiated.Feeds were prepared under laminar floor.95% of calorie and 85% of protein met.+D6 patient kept on NPO due to Melina.TPN@50ml/hr initiated on +D7with on demand RTF@100ml 3rd hourly .Patient met 147% of calorie and 126% of protein requirement.+D13 to+D17 patient was on oral antibacterial liquid diet and met 75% of nutrition requirement.+D18 till discharge(+D26) encouraged neutropenic high protein vegetarian diet with ONS. He met 100% of calorie and protein requirement in immediate post-HSCT period. At time of discharge, after 34 days, egg and whole fruit were introduced along with high protein neutropenic oral diet and ONS. Post discharge telephonic follow-up was done for adherence to antimicrobial diet and high protein intake. Assessment at first visit post discharge revealed a weight gain of 1 kg. This case illustrates that nutritional requirement of HSCT patients could be met adequately by optimising nutrition delivery through enteral and parenteral route. Dedicated nutritional counselling and multi model nutrition intervention is crucial to combat significant risk of malnutrition
Keywords	Keywords: HSCT - haematopoietic stem cell transplantation, optimising Nutrition Support, neutropenic diet.
Field	Medical / Pharmacy
Published In	Volume 7, Issue 4, July-August 2025
Published On	2025-08-07
DOI	https://doi.org/10.36948/ijfmr.2025.v07i04.52184
Short DOI	https://doi.org/g9whw8

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OPTIMISING NUTRITION DELIVERY DURING HAPLOID IDENTICAL STEM CELL TRANSPLANT

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