Pb2415: the role of nutritional support during autologous stem cell transplantation (autohsct) in patients with hodgkin lymphoma.

Topic: 22. Stem cell transplantation - Clinical Background: Correction of metabolic disorders is one of the important point’s supportive care during high-dosechemotherapy with autologous stem cell transplantation (autoHSCT) in patients with Hodgkin’s lymphoma (HL). The impact of nutritional support on recovery during autoHSCT for this group of patients is not clearly understood. Aims: Assess the effect of combined nutritional support on the frequency of mucositis, grade of mucositis, number of nasogastric tube in patients group during high-dose chemotherapy with autoHSCT in patients with HL Methods: The study analyzed 68 patients with Hodgkin’s lymphoma who received high-dose chemotherapy with only parenteral nutritional support (NS) between 2013 and 2016 and 71 patients treated between 2016 and 2020 who received combined NS: combination of parenteral and enteral sipping nutrition. The primary endpoints were the frequency of mucositis, number of nasogastric tube in patients group. The t-test was used to determine the statistical significance of the mean values of equal samples. Results: The duration of agranulocytosis was not statistically differ between groups: a median of 6 days (IQD: 5-8) in the control group versus 7 days (IQD: 6-8) in the combined NS group (p=0.083). The frequency of severe anemia with the need for Erythrocytes transfusion in both groups did not statistically differ, being 82% in the control group and 80.8% in the experimental group. The proportion of patients who required transfusion of erythrocyte suspension (ES) did not differ in the control and experimental groups: 57 (82.0%) vs. 55 (80.4%), p=0.836 (commas instead of dots). At the same time, the number of transfused doses of ES was significantly lower in the experimental group with combined NP compared with the control group without combined NP: median 2 (IQD: 1-2) vs. 3 (IQD: 1-4), p=0.027. This difference was also observed when dividing patients into subgroups (0, 1-2, 3-4, ≥5) according to the number of transfused ES (p=0.029). The relative risk (RR) of developing stomatitis in the combined NS group was lower than in the group without combined NS: RR=0.67 (95% CI 0.49-0.92), p=0.015. Enteral nutritional support was associated with a reduced risk of stomatitis when adjusted for age, sex, and BMI: odds ratio (OR)=0.33, 95% CI 0.14-0.78, p=0.012. The RR of developing colitis in the combined NS group was lower: RR=0.58 (95% CI 0.36-0.94), p=0.026. Enteral nutritional support was associated with a reduced risk of colitis after adjusting for age, sex, and baseline BMI: OR=0.38, 95% CI 0.17-0.86, p=0.021. A nasogastric tube was placed statistically less frequently in the combined NS group: 3.0% (n=2) versus 19.6% (n=10), p=0.015. Enteral nutritional support was associated with a reduced frequency of nasogastric tube insertion when adjusted for age, sex, and baseline BMI: OR=0.16, 95%CI 0.03-0.83, p=0.029. In patients with an installed nasogastric tube, the duration of its stay did not statistically significantly differ between groups with and without combined NS: median 6 days (IQD: 4-8) vs. 5 days (IQD: 3-6), respectively (p=0.382). Summary/Conclusion: The data obtained show that combined nutritional support reduces the risk of mucositis, reduces the during frequency of nasogastric tube insertion autoHSCT in patients with Hodgkin’s lymphoma. Enteral nutritional support was associated with a reduced risk of colitis and stomatitis. Keywords: Hodgkin’s lymphoma, Autologous hematopoietic stem cell transplantation, Infection, Supportive care