Possible clinical outcomes using early enteral nutrition in patients with allogeneic hematopoietic stem cell transplantation: a single-center retrospective study

Abstract Intensive nutritional support during allogeneic hematopoietic stem cell transplantation (allo-HSCT) yields improved clinical outcomes. However, the clinical implications of early enteral nutrition (EN) in allo-HSCT remain unclear. This retrospective study was conducted to determine the significance of early EN in patients who underwent allo-HSCT and the association between early nutritional intervention and clinical outcomes, including the status of the intestinal microbiome. Thirty-one patients received EN before conditioning. The median body mass variation was only −0.35 kg on day 60. The probability of a 2-year overall survival (OS) was 61.1%. The cumulative incidence of TRM was 17.4% and those of acute graft-versus-host-disease (aGVHD) were 32.3% (grades II–IV) and 3.2% (grades III–IV), respectively. Chronic GVHD was observed in four patients. The intestinal microbiota was examined by meta 16S rRNA gene sequencing of fecal samples. Dysbiosis of intestines and aGVHD occurred simultaneously, and Enterococcus species were abundant. Our results suggest that early nutritional support can improve the outcomes of patients who have undergone allo-HSCT and maintain homeostasis of their intestinal microbiome. Future prospective clinical trials are required to elucidate the role of EN in allo-HSCT and association between the intestinal microbiome and EN.