[The Impact of Nutritional Intervention on Complications and Prognosis of Hematopoietic Stem Cell Transplantation Patients].

OBJECTIVE: To investigate the effects of nutritional supportive therapy on hematopoietic stem cell transplantation (HSCT) patients and to analyze its relationship with post-transplant hematopoietic reconstitution, acute graft-versus-host disease (aGVHD).

METHODS: The clinical data of 76 HSCT patients in our hospital were collected from November 2020 to November 2023, included 46 cases in the nutritional intervention group and 30 in the non-intervention group. After assessing the nutritional status of the intervention group, the five-step therapy principle was followed to implement refined nutritional support treatment, the total daily energy requirement by the patients was calculated based on 25-30 kcal/(kg·d) from the first day of pretreatment to 90 days post-transplantation, followed up until March 2024. The nutritional indices and clinical outcomes of both groups pre-transplant and at 30, 60, and 90 days post-transplant was observed.

RESULTS: At 30 days and 60 days after transplantation, the total protein level in the intervention group was higher than before transplantation (P<0.05). At 30 days, 60 days, and 90 days after transplan-tation, the triglyceride levels in both groups were higher than before transplantation (P<0.05). At 30 days and 90 days after transplantation, the HDL-C level in the intervention group was lower than before transplantation (P<0.05). At 60 days after transplantation, the BMI level in the intervention group was higher than that in the non-intervention group (P<0.05). At 30, 60, and 90 days after transplantation, the albumin level in the intervention group was higher than that in the non-intervention group (P<0.05). At 30 days after transplantation, the prealbumin level in the intervention group was higher than that in the non-intervention group (P<0.05). At 30 days and 60 days after transplantation, the total protein level in the intervention group was higher than that in the non-intervention group (P<0.05). At 60 days after transplantation, the low density lipoprotein cholesterol (LDL-C) and triglyceride levels in the intervention group were lower than those in the non-intervention group (P<0.05). At 30 days after transplantation, the HDL-C level in the intervention group was lower than that in the non-intervention group (P<0.05). Time of hematopoietic recons-truction after transplantation: the days for granulocyte reconstitution in the intervention group were earlier than those in the non-intervention group (P<0.05), while there was no statistically significant difference in the number of days for megakaryocyte reconstitution between the two groups (P＞0.05). At 30 days after transplantation, the level of soluble growth stimulus expression gene 2 protein (sST2) in the intervention group was significantly lower than that in the non-intervention group (P<0.05). The level of soluble interleukin-2 receptor (sCD25) in the intervention group at 60 days after transplantation was lower than that at 30 days after transplantation (P<0.05). At different time points after transplantation, there was no statistically significant differences between the two groups in regenerative lslet derived protein 3 alpha (REG3α), soluble tumor necrosis factor receptor 1 (sTNFR1), and elastase inhibitory factor (Elafin) (P＞0.05).

CONCLUSION: The implementation of nutritional support therapy not only ameliorates malnutrition and hastens granulopoiesis, but also mitigates the risk of aGVHD and improves the prognosis of patients undergoing hematopoietic stem cell transplantation.