Nutritional Support in Adult Patients Undergoing Allogeneic Stem Cell Transplantation Following Myeloablative Conditioning

  • Nicolas Danel Buhl
  • David Seguy
Living reference work entry


Allogeneic stem cell transplantation (allo-SCT) and its consequences are a perfect illustration of the different pathophysiological pathways leading to protein–energy malnutrition, which is characterized by a decrease in oral intake, an increase in metabolic needs, and the appearance of digestive losses. Malnutrition is a crucial target because of its consequences for morbidity and mortality in recipients. Thus, nutritional assessment, counseling, and intervention should be incorporated systematically into the care of each patient. Posttransplantation support includes monitoring of nutritional status and metabolic disorders, prevention of micronutrient deficiencies, promotion of low-microbial oral feeding, and rational use of both enteral nutrition (EN) and parenteral nutrition (PN). Rather than being opposing strategies, EN and PN are complementary in the care of disease-related malnutrition. EN appears useful for limiting gut atrophy and bacterial translocation, which promote sepsis and acute graft-versus-host disease, whereas PN becomes a rescue option when oral or enteral intake is insufficient or impossible. However, PN cannot substitute for the effect of EN on gut trophicity. Future research on nutritional support for allo-SCT patients should focus on this complementarity and should define more precisely the place of immunonutrients, such as glutamine, according to the type of transplant.


Parenteral Nutrition Enteral Nutrition Conditioning Regimen Oral Mucositis Bacterial Translocation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations


Allogeneic stem cell transplantation


Antigen-presenting cells


Body mass index


Enteral nutrition


Graft-versus-host disease


Interferon gamma


Interleukin 1

MAC allo-SCT

Allogeneic stem cell transplantation following myeloablative conditioning


Parenteral nutrition


Tumor necrosis factor alpha


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.INSERM U995Faculté de Médecine, Université de LilleLilleFrance
  2. 2.Service de NutritionHôpital Claude Huriez – CHRU de LilleLilleFrance

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