Hematologic malignancies, including leukemia, lymphoma, and myeloma, affect tens of thousands of adults each year. While advances in treatment have improved survival, therapies such as chemotherapy, radiation, and stem cell transplant often cause side effects that impair oral intake and overall nutritional status.
Nutrition support, delivered via tube feeding (enteral nutrition) or intravenously (parenteral nutrition), is commonly used to help patients meet their nutritional needs during treatment. Dietitians play a critical role in optimizing nutrition to support treatment tolerance, outcomes, and quality of life for this complex, high-risk population.
Recently published in the Journal of the Academy of Nutrition and Dietetics, a systematic review and meta-analysis was conducted by the Academy's Evidence Analysis Center to evaluate the role of nutrition support interventions in hospitalized adults with hematologic malignancies on outcomes including nutritional status, anthropometrics, hospital length of stay, readmission rates, quality of life and other clinical measures.
The review included 21 studies, randomized controlled trials and observational studies, representing more than 2,100 patients. However, evidence was limited for several outcomes. Overall, no single nutrition support approach demonstrated consistent superiority across all outcomes.
Meta-analysis suggested that enteral nutrition (EN) was associated with a shorter hospital length of stay compared to parenteral nutrition (PN), while glutamine-enriched interventions showed no clear benefit; however, overall certainty of evidence was very low.
Despite these limitations, the evidence did support current best practices: prioritizing enteral nutrition when possible and tailoring nutrition support to each patient's individual needs. These findings highlight important gaps in the current evidence and underscore the need for additional high-quality research to better understand which nutrition support interventions are most effective for hospitalized adults with hematologic malignancies.
Research for this effort was funded by the Academy of Nutrition and Dietetics Foundation's Research Endowment through its Evidence Analysis Center summer fellowship program.
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