Výživa pacientov podstupujúcich transplantáciu hematopoetických kmeňových buniek

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Authors: B. Kašperová ¹; M. Mego ²; S. Čierniková ³; A. Ševčíková ³; S. Kašperová ⁴; A. Vranovský ¹; L. Drgoňa ¹
Authors‘ workplace: Department of Oncohematology, Faculty of Medicine, Comenius University, Bratislava, and National Cancer Institute, Bratislava, Slovakia ¹; 2nd Department of Oncology, Faculty of Medicine, Comenius University, Bratislava, and National Cancer Institute, Bratislava, Slovakia ²; Department of Genetics, Cancer Research Institute, Biomedical Research Center of the Slovak Academy of Sciences, Bratislava, Slovakia ³; 1st Department of Internal Medicine, Faculty of Medicine, Comenius University in Bratislava, and University Hospital Bratislava, Slovakia ⁴
Published in: Klin Onkol 2025; 38(5): 345-357
Category: Reviews
doi: https://doi.org/10.48095/ccko2025345

Overview

Východiská: Transplantácia hematopoetických kmeňových buniek je spojená so zvýšenými požiadavkami na adekvátny príjem kalórií a rizikom vyčerpania makroživín a mikroživín. Z makroživín sú to sacharidy, bielkoviny a tuky, ktoré predstavujú kľúčový zdroj energie a stavebných zložiek pre transplantovaných pacientov často trpiacich obmedzeným príjmom potravy v dôsledku mukozitídy a stratou chuti do jedla, tiež zvýšenými nutričnými požiadavkami v dôsledku katabolizmu, zápalu a regenerácie tkanív. Nedostatok vitamínov a stopových prvkov zohráva zase kľúčovú úlohu v enzýmových reakciách, antioxidačnej obrane, imunitnej funkcii a regenerácii tkanív. Prípravný režim má tiež za následok poškodenie črevnej sliznice a v kombinácii s antibiotickou terapiou nepriaznivo znižuje diverzitu mikrobiómu. Podľa najnovších dôkazov má výživa pacientov vplyv na krátkodobé a dlhodobé výsledky transplantácie. Rozpoznanie malnutrície a katabolizmu u týchto pacientov je v bežnej praxi ťažké; užitočná môže byť podrobnejšia analýza zloženia tela a včasná intervencia klinického výživového poradcu. Primeraná náhrada živín je dôležitým aspektom udržiavania nutričnej rovnováhy a dobrého zotavenia. Cieľ: Cieľom tohto článku je poskytnúť prehľad o výžive, jej špecifických zložkách a nutričných poruchách u onkologických pacientov, ako aj zosumarizovať špecifické komplikácie agresívnej liečby u pacientov podstupujúcich transplantáciu hematopoetických kmeňových buniek a zdôrazniť potrebu včasnej nutričnej intervencie u tejto skupiny pacientov.

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