Nutritional support in patients with GVHD of the digestive tract: state of the art

van der Meij, B S; de Graaf, P; Wierdsma, N J; Langius, J A E; Janssen, J J W M; van Leeuwen, P A M; Visser, O J
April 2013
Bone Marrow Transplantation;Apr2013, Vol. 48 Issue 4, p474
Academic Journal
An important complication of allo-SCT is GVHD, which commonly affects the skin, liver and digestive tract. Clinical symptoms of GVHD of the digestive tract (GVHD-DT) include excessive diarrhoea, abdominal pain and cramps, nausea and vomiting, gastrointestinal bleeding, dysphagia, and weight loss. Treatment is complicated and regarding nutritional support, only a few guidelines are available. Our aim was to critically appraise the literature on nutritional assessment, nutritional status and nutritional support for patients with GVHD-DT. Evidence shows that GVHD-DT is often associated with malnutrition, protein losing enteropathy, magnesium derangements, and deficiencies of zinc, vitamin B12 and vitamin D. Limited evidence exists on derangements of magnesium, resting energy expenditure, bone mineral density and pancreatic function, and some beneficial effects of n-3 polyunsaturated fatty acids and pancreatic enzyme replacement therapy. Expert opinions recommend adequate amounts of energy, at least 1.5 g protein/kg body weight, supplied by total parenteral nutrition in cases of severe diarrhoea. When diarrhoea is <500 mL a day, a stepwise oral upgrade diet can be followed. No studies exist on probiotics, prebiotics, dietary fibre and immunonutrition in GVHD-DT patients. Future research should focus on absorption capacity, vitamin and mineral status, and nutritional support strategies.


Related Articles

  • Weight loss and reduced body mass index: a critical issue in children with multiorgan chronic graft-versus-host disease. Browning, B.; Thormann, K.; Seshadri, R.; Duerst, R.; Kletzel, M.; Jacobsohn, D. A. // Bone Marrow Transplantation;Mar2006, Vol. 37 Issue 5, p527 

    Weight loss and malnutrition are major problems in patients with chronic graft-versus-host disease (GVHD). In adults, low body mass index (BMI) is a predictor for mortality; however, weight loss and BMI have not been studied in pediatric chronic GVHD. A retrospective study on 18 children with...

  • ENZO BIOCHEM TREATMENT RIDS TRANSPLANTATION SIDE EFFECTS.  // Worldwide Biotech;Jul2000, Vol. 12 Issue 7, p1 

    Reports on the treatment developed by scientists at Hadassah University Hospital and Enzo Biochem Inc. which reversed the side effects of a graft versus host disease in an individual receiving bone marrow stem cell transplantation.

  • A Follicular Lichenoid Eruption as Manifestation of Chronic Graft-vs-Host Disease. Valks, R.; Vargas, E.; Fraga, J.; Peñas, P. F.; Fernández-Herrera, J. // Acta Dermato-Venereologica;09/01/98, Vol. 78 Issue 5, p386 

    Presents a case report of a bone marrow transplant patient who developed chronic graft-vs-host disease (GVHD) characterized by peculiar, follicular, lichenoid eruptions. Medical history of the patient; Medications given to the patient; Rarity of follicular eruption being the major clinical...

  • graft-versus-host disease.  // Taber's Cyclopedic Medical Dictionary (2009);2009, Issue 21, p979 

    A definition of the term "graft-versus-host disease" (GVH), which refers to the immunological injury suffered by an immunosuppressed recipient of a bone marrow transplant, is presented.

  • Posaconazole prophylaxis a winner in patients with GVHD.  // PharmacoEconomics & Outcomes News;1/21/2012, Issue 645, p9 

    The article discusses research being done on the cost effectiveness of posaconazole in patients with graft-versus-host-disease (GVHD), referencing a study by A. K. O'Sullivan et al, published in the January 15, 2012 issue of the "American Journal of Health-System Pharmacy."

  • Antineutrophil cytoplasmic antibodies (ANCA) in chronic graft-versus-host disease after allogeneic bone marrow transplantation. Martin, S J; Audrain, M A P; Oksman, F; Ecoiffier, M; Attal, M; Milpied, N; Esnault, V L M // Bone Marrow Transplantation;7/1/97, Vol. 20 Issue 1, p45 

    We studied the usefulness of monitoring antineutrophil cytoplasmic antibodies (ANCA) in chronic graft-versus-host disease (cGVHD), a major complication of allogeneic bone marrow transplantation. Antigen-specific ELISA and indirect immunofluorescence (IIF) were used to search for ANCA in 47...

  • Response from Dr Gaziev. Gaziev, D // Bone Marrow Transplantation;8/15/2000, Vol. 26 Issue 4, p461 

    Focuses on chronic graft-versus-host-disease.

  • Playing host to rash and raging diarrhea. Greenwald, David A.; Brandt, Lawrence J. // Cortlandt Forum;6/25/96, Vol. 9 Issue 6, p168 

    Presents an analysis of a medical case involving a 49-year-old man who was previously diagnosed with multiple myeloma and treated with high doses of chemotherapeutic drugs followed by allogeneic peripheral stem cell transplant. Development of maculopapular rash involving the trunk, palms and...

  • Chronic intestinal graft-versus-host disease: clinical, histological and immunohistochemical analysis of 17 children. de Serre, N. Patey-Mariaud; Reijasse, D.; Verkarre, V.; Canioni, D.; Colomb, V.; Haddad, E.; Brousse, N. // Bone Marrow Transplantation;2/1/2002, Vol. 29 Issue 3, p223 

    Presents a study which investigated the clinical, histological and immunohistochemical features of chronic graft-versus-host disease. Background on the disease; Methodology; Results and discussion.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics