Nonrestrictive diet does not increase infections during post-HSCT neutropenia: data from a multicenter randomized trial

• DOI: 10.1182/bloodadvances.2023010348
• Publication Date: 2023-07-14T16:47:59Z
• Authors: Federico Stella; Vincenzo Marasco; Giorgia Virginia ...; Anna Guidetti; Annamaria De Filippo; Martina Pennisi; Cecilia Vismara; Rosalba Miceli; Silva Ljevar; Cristina Tecchio; Nicola Mordini; Giorgia Gobbi; Lucia Saracino; Paolo Corradini
• Keywords: Mucositis

Infections are a major cause of morbidity and mortality during neutropenia after hematopoietic stem cell transplantation (HSCT). The use low-microbial protective diet (PD) in the peritransplantation period is standard care, although its efficacy has never been tested prospectively. We conducted multicenter, randomized, noninferiority trial, enrolling all consecutive adult patients undergoing high-dose induction chemotherapy or HSCT with objective to compare nonrestrictive (NRD) vs PD. Overall, 222 were enrolled, randomly assigned, analyzed. One hundred seventy-five subjects (79%) received autologous (auto-HSCT), 41 (18%) allogeneic (allo-HSCT), 6 (3%) chemotherapy. There was no significant difference terms incidence grade ≥2 infections death 2 arms. In multivariable analysis, only multiple myeloma diagnosis, fluoroquinolone prophylaxis, absence mucositis associated lower infections. did not report any variation hospitalization length, gastrointestinal infections, body weight, serum albumin variations allo-HSCT recipients, acute graft-versus-host disease ≥3 similar. NRD higher patient-reported satisfaction. conclusion, inferior traditional PD HSCT, our results demonstrated that implementing restrictive unnecessary burdens patients' quality life. clinical trial registered prospectively registry Istituto Nazionale dei Tumori Milan as INT54/16.