NUTRIZIONE PARENTERALE IN BAMBINI CON NEOPLASIA MALIGNA SOTTOPOSTI A CHEMIOTERAPIA AGGRESSIVA

Translated title of the contribution: Total parenteral nutrition in children with cancer under aggressive chemotherapy with or without autologous bone marrow transplantation

A. Garaventa, E. Lanino, S. Dallorso, G. Dini, P. Buffa, I. Baldelli, C. Viscoli, B. De Bernardi, L. Massimo

Research output: Contribution to journalArticlepeer-review

Abstract

The incidence of malnutrition has been well documented in children with cancer. Many causes interfere with nutritional status such as tumor catabolism, surgery, chemotherapy, radiotherapy, which may affect gastrointestinal function. This is specially appreciated in those children undergoing bone marrow transplantation (BMT), a procedure which entails massive doses of chemotherapy along with total body irradiation, which may cause severe gastrointestinal toxicity requiring total parenteral nutrition (TPN) as an essential support to survival. We report here our experience with 25 children who underwent 29 separate courses of TPN during and/or after intensive chemotherapy; 11 of these patients had undergone autologous BMT (ABMT) following ablative treatment. Age ranged from 2 months to 17 years; diagnosis was: stage IV neuroblastoma in 12 cases, acute non lymphocytic leukaemia in 6, non Hodgkin's lymphoma in 3, Ewing's sarcoma in 2, rhabdomyosarcoma and nephroblastoma in 1 case each. Duration of TPN ranged from 15 to 64 days. Children received a caloric intake of 66 ± 17.3 Kcal/kg/day and a nitrogen intake of 0.29 ± 0.08 g/kg/day. Nutritional assessment, utilizing percent ideal body weight and serum albumin levels, was performed at the beginning and at the completion of each course, as well as during TPN when indicated. The mean percent ideal body weight was found 89.4 ± 13.1 before TPN and 94.6 ± 14.2 on the last day of TPN; only one patient failed to gain weight. Mean pre-TPN serum level of albumin was 3.3 ± 0.42 g/dl and it was found increased to 3.47 ± 0.3 at the end of TPN. Sepsis occurred in 14 cases during periods of severe neutropenia: 7 caused by bacteria, 6 by fungi and 1 by both; 2 of them were clearly catheter related. No sepsis related death occurred. Our experience indicates that TPN provides sufficient caloric intake and prevents loss of lean body mass in this population of patients, representing a relatively safe and effective supportive measure in children with cancer at high risk for protein caloric malnutrition.

Translated title of the contributionTotal parenteral nutrition in children with cancer under aggressive chemotherapy with or without autologous bone marrow transplantation
Original languageItalian
Pages (from-to)159-164
Number of pages6
JournalRivista Italiana di Nutrizione Parenterale ed Enterale
Volume4
Issue number3
Publication statusPublished - 1986

ASJC Scopus subject areas

  • Food Science
  • Anatomy
  • Critical Care and Intensive Care Medicine
  • Nutrition and Dietetics

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