Nutrition Issues in Hematopoietic Cell Transplantation: Latest Advances

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This webinar was presented live on November 4, 2020.

Patients undergoing hematopoietic cell transplantation are a highly heterogenous population in terms of their nutrient needs and requirement for nutrition intervention. The implications of dose-intensive conditioning regimens, coupled with the debilitating effects of graft-versus-host disease (GVHD), can be extremely complex and adversely affect the patient's nutritional status. Decreased oral intake, increased nutrient requirements, and impaired nutrient utilization often necessitate medical nutrition therapy. The use of standard supportive care measures, including parenteral nutrition (PN), enteral nutrition (EN), and other dietary intervention strategies, such as the immunosuppressed diet, have varied over the past four decades and are highly dependent upon the type of transplant being utilized. This webinar will review nutrition support practices, including discussion on the appropriate use of PN and EN, evidence-based diet recommendations for immunosuppressed transplant recipients, and nutrition implications associated with gastrointestinal GVHD.

CPEU: 1
CPE Level: 2
Learning Need Codes: 5150, 5440, 5220
Performance Indicators: 8.3.1, 8.3.6, 8.1.1

Learning Objectives

1. Review nutrition support practices, including indications for parenteral nutrition and enteral nutrition support, during hematopoietic cell transplantation (HCT).
2. Describe evidence-based diet recommendations for immunosuppressed HCT recipients.
3. Understand the pathophysiology of graft-versus-host disease and appropriate nutrition interventions.

Speaker

Paula Charuhas Macris MS, RD, CSO, FAND, CD

Paula Charuhas Macris, MS, RD, CSO, FAND, received her undergraduate and graduate degrees from the University of Washington. For over the past 30 years, she has worked at the Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance in Seattle, Washington as the Nutrition Education Coordinator/Pediatric Nutrition Specialist. Paula's area of expertise is hematopoietic cell transplantation. She has been involved in patient care, clinical research, food safety practices, staff education, and training of dietetic interns. Paula has presented at over 100 local, national, and international conferences and has published over 60 review articles, research papers, and book chapters. Her involvement with the Oncology Nutrition Dietetic Practice Group (ON DPG) has included Western Area Representative, Continuing Education Chair, Treasurer, past symposium speaker, author of practice group publications, and reviewer of the Oncology Nutrition Connection. Paula was the recipient of the 2019 ON DPG Distinguished Practice Award and 2003 Academy of Nutrition and Dietetics Foundation Excellence in Clinical Practice Award.