Chapter 16: MNT for Hematopoietic Cell Transplantation Flashcards
What conditions are treated by Hematopoietic cell transplantation?
Acute/chronic leukemia Lymphoma Hodgkin's disease Myelodysplastic syndrome Multiple myeloma
advanced stage neuroblastoma
refractory Ewing’s sarcoma
What are the general needs for an adult transplant patient?
Calories: Basal needs x 1.3-1.5
Protein: 1.5 g/kg
CHO: 50-60% of total
FAT: Min 6-8%, Max 40%
What are some of the food restrictions for immunosuppressed patients?
raw/undercooked meat, fish, poultry, eggs, sausage, bacon
raw tofu unless pasteurized
luncheon meat unless heated to steaming
refrigerated smokes seafood like smoke, fish jerky, pickled fish
unpasterurized milk and milk products
blue-veined cheeses
soft cheeses
mexican-style soft cheeses
fresh salad dressing
unwashed raw/frozen fruits/vegetables and those with visible mold, sprouts
unpasteurized juices
well water must be boiled for 15-20 minutes and consumed within 48 hrs
What are nutritional considerations during HCT to be aware of?
Oral/GI complications - N/Mucositis/Early Satiety Sinusoidal Obstructive Syndrome (SOS) Renal impairment Graft-Versus-Host Disease (GVHD) Infection
What are long term complications from HCT?
Chronic GVHD Osteoporosis Growth and Development Issues Endocrine Complications Iron Overload
Name the common meds used for treatment of GVHD?
Anti-thymocyte Globulin Azathioprine Beclomethasone Dipropionate Budesonide Corticosteroids Cyclosporine Extra Corporeal Photopheresis (ECP) Methotrexate Monoclonal Antibodies Mycophenolate Mofetil Pentostatin Psoralen + Ultraviolet light Sirolimus Tacrolimus Thalidomide Ursodexycholic acid
What are the phases of diet for GVHD?
Bowel rest - NPO
Intro to oral feeding - isotonic, low-residue, low-lactose fluids
Intro of solids - min lactose, low fiber, low fat, low total acidity, no gastric irritants
Expansion of Diet - same with more introductions
Resumption of reg diet - same progression
