The impact of counseling on nutritional status among hematopoietic stem cell recipients: results of a randomized controlled trial

Abstract

Conditioning regimen accompanying hematopoietic stem cell transplantation (HSCT) is associated with severe gastro-intestinal toxicity, commonly compromising patients’ food intake, nutritional status, and functioning level [1, 2]. Studies assessing malnutrition rates in HSCT showed that malnutrition rates are low at admission (ranging between 4 and 6%), elevated at hospital discharge (ranging between 35 and 60%), and gradually decreases post discharge [2, 3]. A prospective cohort study suggested that even though patients had improved quality of life, physical activity levels, and lean body mass post HSCT, they did not regain their pre-HSCT levels 100 days post transplantation compared to admission. All patients at discharge and half the patients 100 days post HSCT required a nutrition intervention, when assessed with the patient-generated subjective global assessment (PGSGA) nutritional assessment tool [2].

Nutrition support recommended as part of a model for cancer cachexia rehabilitation was associated with an improved nutritional status among cancer patients [4]. The effect of nutritional counseling has not been well studied among HSCT post hospital discharge. The aim of this open-label randomized controlled trial (RCT) was to assess the effect of nutritional counseling provided monthly at and post hospital discharge on nutritional status at 100 days post HSCT.