Is There a Difference in Body Composition of Autologous Hematopoietic Stem Cell Transplantation Recipients on Enteral versus Parenteral Nutritional Support? A Pilot Study

Abstract

Background

Parenteral nutrition (PN) is the current standard of nutritional care for autologous hematopoietic stem cell transplantation (AHSCT) recipients. However, the American Society for Parenteral and Enteral Nutrition recommends using enteral nutrition (EN), because PN is more expensive and associated with higher rates of infection. Currently, there is minimal evidence examining body composition (BC) in AHSCT recipients on EN versus those on PN. Our study aimed to determine differences in BC, including muscle mass, phase angle, percent body fat, and muscle strength, in these 2 groups of patients.

Methods

Thirty-five AHSCT recipients were randomized to receive EN or PN. Participants were followed at baseline and 15 days and 30 days post-transplantation. Bioelectrical impedance analysis was used to measure fat mass (FM), lean body mass (LBM), and phase angle (PhA). The Z-fat-free mass index (FFMI) was calculated. Ultrasound was used to assess quadriceps muscle layer thickness (QMLT), and a dynamometer evaluated hand grip strength (HGS). Population means were used to calculate standardized PhA (SPhA). The t tests and χ² test were performed with SPSS software. A P value <.05 was considered to indicate statistical significance.

Results

The study cohort comprised 16 EN patients and 19 PN patients, with a mean age of 61.2 ± 9.66 years. There were no significant differences between the groups in QMLT, FM, z-FFMI, HGS, SPhA, and LBM at baseline, day 15, or day 30.

Conclusion

AHSCT recipients on EN had similar body composition to those on PN, providing convincing evidence that EN may be an acceptable and less expensive nutritional modality in AHSCT recipients.