Parenteral nutrition following intensive cytotoxic therapy: an exploratorystudy on the need for parenteral nutrition after various treatment approaches for haematological malignancies

Patients receiving intensive cytotoxic therapy are traditionally supported with parenteral nutrition (PN), although it is unclear whether all patients benefit from PN, This study aimed to identify regimen-associated differenc es in PN requirements, to reveal discrepancies between the number of PN ind ications and the frequency,vith which PN was actually given, and to describ e characteristics of patients who met nutritional goals without PN, PN indi cations were defined as: (1) severe malnutrition at admission; (2)a prolong ed period (7-10 days) of minimal oral intake; or (3) clinical weight loss > 10%. PN was found to be needed in only 35% of consolidation courses, compar ed with 80% during remission induction and 55% during BMT, Significant diff erences were also seen between BMT protocols: PN was required in only 37% o f autologous BMT recipients conditioned without total body irradiation (for lymphoma) vs 92% of recipients of a mismatched graft. A high body mass ind ex was the only significant characteristic of patients who could do without PN. In conclusion, PN is not required for all patients undergoing intensiv e cytotoxic therapy. Screening of nutritional status at the start of therap y and monitoring oral intake following cytotoxic treatment may allow more a ppropriate identification of patients requiring PN.