Nutritional outcomes associated with enteral versus parenteral nutritional support during intensive induction chemotherapy for acute myeloid leukemia.
In a two-center retrospective cohort of 327 adults with AML receiving intensive induction chemotherapy, enteral nutrition was associated with less weight loss, higher albumin levels, and less severe malnutrition than parenteral nutrition, without a significant overall-survival difference.
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In a two-center retrospective cohort of 327 adults with AML receiving intensive induction chemotherapy, enteral nutrition was associated with less weight loss, higher albumin levels, and less severe malnutrition than parenteral nutrition, without a significant overall-survival difference.
Research significance
The reported association suggests—but does not establish—that prioritizing enteral over parenteral nutrition during intensive AML induction could better preserve nutritional status; prospective controlled studies are needed to determine causality, safety, treatment-tolerance effects, and applicability to pediatric patients.
Source abstract
PURPOSE: During acute myeloid leukemia (AML) intensive chemotherapy induction, nutrition is an important part of supportive care and may influence treatment tolerance and clinical outcomes, impacting patient prognosis. Several nutritional supports can be used to limit malnutrition, but limited data are available to guide the choice of nutritional support. This study aimed to compare nutritional outcomes associated with enteral nutrition (EN) and parenteral nutrition (PN) during intensive induction chemotherapy for AML in a real-world retrospective setting. METHODS: A retrospective observational study was conducted in two French academic centers (Angers University Hospital and Rennes University Hospital), including all adult patients with AML receiving intensive induction chemotherapy. RESULTS: Between January 2017 and March 2022, 327 patients were included, with a median age of 60 years (range 18-81). Among these patients, 265 (81%) patients received nutritional support during induction therapy: enteral nutrition (EN) for 135 patients and parenteral nutrition (PN) for 130 patients. Patients who received EN had better nutritional status at the end of induction therapy with lower weight loss (5% vs. 6.7%, P = 0.012), higher albumin levels (32 vs. 27.9, P < 0.001), and less severe nutritional index (NRI; 24% vs. 57%, P < 0.001) compared to the PN group. However, no significant difference was observed in overall survival between the two groups. CONCLUSION: In this retrospective comparison of two institutional nutritional support strategies, patients initially managed with EN experienced lower weight loss and lower rates of severe malnutrition at the end of induction therapy.