Evaluation of Total Parenteral Nutrition in the Autologous Transplantation Setting in Patients with AML: A Retrospective Exploratory Analysis

Abstract

Malnutrition remains a clinical challenge in AML patients undergoing autologous hematopoietic stem cell transplantation (ASCT), leading to physical deconditioning and prolonged hospitalization. Prospective data are mainly lacking to identify those patients who may particularly benefit from parenteral nutrition in this setting. This observational, non-randomized, retrospective, exploratory cohort study assessed the nutritional development in patients following high-dose chemotherapy (HDCT) with ASCT and explored their survival outcomes. The study included all consecutive AML patients who underwent HDCT with ASCT at a single academic center between January 2000 and January 2019. Patients were divided into two primary cohorts: those who received TPN following high-dose chemotherapy and ASCT and those who did not. We identified 126 patients with AML in first complete remission undergoing ASCT consolidation, including 75 patients receiving TPN after HDCT and ASCT and 51 patients without TPN. Neither group differed in gender, age, or subgroups of AML. The nutritional condition at first diagnosis and after induction chemotherapy was equal in both groups, as were median weight changes throughout the induction chemotherapy cycles. Finally, progression-free and overall survival rates were comparable in both groups. Our data suggest that the need to provide TPN for an average of 11 days following HDCT with ASCT for consolidation of first remission in AML patients does not affect the clinical outcome of these patients.