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Original ArticleOpen Access
Nutritional Support in Pediatric Patients Undergoing Bone Marrow Transplantation
lsariyavuth V 
,
Suthutvoravut U ,
Chatvuttinun S ,
Chantraruksa V ,
Kasemsup R ,
Krasaesub S ,
Hongeng S
,
Suthutvoravut U ,
Chatvuttinun S ,
Chantraruksa V ,
Kasemsup R ,
Krasaesub S ,
Hongeng S Background : Children undergoing bone marrow transplantation (BMT) are prone to develop
severe gastrointestinal (GI) complications and metabolic imbalance which consequently impair their
nutritional status. Nutritional support is an important adjunctive treatment during BMT.
Objective : To assess GI complications, metabolic complications and nutritional outcome
of children undergoing BMT with nutritional support intervention.
Method : Retrospective study of 20 children (median age 6.8 years, 11 males) undergoing
BMT at Ramathibodi Hospital from March 1995 to July 2000 was conducted. Their medical records
were reviewed.
Results : The patients underwent autologous (n = 9) and allogenic BMT (n = 11). Median
z-scores of weight for age, height for age and weight for height were 0.06 ± 1.93, -0.55 ± 1.18 and
0.48 ± 1.94, respectively. Nineteen patients had vomiting for 9.8 ± 5.5 days. Eighteen patients developed
diarrhea for 9.6 ± 7.2 days. The durations of vomiting and diarrhea, as a percentage of total
hospital days, were 33.5 ± 16.3 per cent and 30.4 ± 17.0 per cent, respectively. There were no differences
between the patients with autologous and allogenic BMT regarding these durations. All patients
needed enteral and/or parenteral nutrition support for 21.0 ± 7.7 days except for one patient who could
take adequate oral intake. The duration of enteral nutrition support was not significantly different
between the groups but the duration of parenteral nutrition support was significantly longer in the
allogenic group. Metabolic complications were hypokalemia, hypophosphatemia and one case of
arrhythmia secondary to hypomagnesemia. All patients developed febrile neutropenia but none developed
catheter-related sepsis. The length of hospital stay was 30.5 ± 10.2 days. The median z-score
of weight for height on the day of discharge was 1.08 ± 2.03.
Conclusion : Children undergoing BMT usually have GI symptoms of vomiting, diarrhea
and mucositis as well as metabolic imbalances such as hypokalemia, hypophosphatemia and hypomagnesemia.
Despite these complications, their nutritional status could be restored by proper nutritional
support.
Key word : Nutritional Support, Bone Marrow Transplantation
severe gastrointestinal (GI) complications and metabolic imbalance which consequently impair their
nutritional status. Nutritional support is an important adjunctive treatment during BMT.
Objective : To assess GI complications, metabolic complications and nutritional outcome
of children undergoing BMT with nutritional support intervention.
Method : Retrospective study of 20 children (median age 6.8 years, 11 males) undergoing
BMT at Ramathibodi Hospital from March 1995 to July 2000 was conducted. Their medical records
were reviewed.
Results : The patients underwent autologous (n = 9) and allogenic BMT (n = 11). Median
z-scores of weight for age, height for age and weight for height were 0.06 ± 1.93, -0.55 ± 1.18 and
0.48 ± 1.94, respectively. Nineteen patients had vomiting for 9.8 ± 5.5 days. Eighteen patients developed
diarrhea for 9.6 ± 7.2 days. The durations of vomiting and diarrhea, as a percentage of total
hospital days, were 33.5 ± 16.3 per cent and 30.4 ± 17.0 per cent, respectively. There were no differences
between the patients with autologous and allogenic BMT regarding these durations. All patients
needed enteral and/or parenteral nutrition support for 21.0 ± 7.7 days except for one patient who could
take adequate oral intake. The duration of enteral nutrition support was not significantly different
between the groups but the duration of parenteral nutrition support was significantly longer in the
allogenic group. Metabolic complications were hypokalemia, hypophosphatemia and one case of
arrhythmia secondary to hypomagnesemia. All patients developed febrile neutropenia but none developed
catheter-related sepsis. The length of hospital stay was 30.5 ± 10.2 days. The median z-score
of weight for height on the day of discharge was 1.08 ± 2.03.
Conclusion : Children undergoing BMT usually have GI symptoms of vomiting, diarrhea
and mucositis as well as metabolic imbalances such as hypokalemia, hypophosphatemia and hypomagnesemia.
Despite these complications, their nutritional status could be restored by proper nutritional
support.
Key word : Nutritional Support, Bone Marrow Transplantation
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