ASH 2022 | Neutrodiet trial: comparing infections using NRD and PD in patients with neutropenia after HSCT

Infections occurring in the period of neutropenia following high-dose chemotherapy are a leading cause of morbidity and mortality. One method used to prevent infections in patients with neutropenia after hematopoietic stem cell transplantation (HSCT) is the use of a low-microbial protective diet (PD). PD has been used extensively among bone marrow transplantation (BMT) centers even though its efficacy has never been tested prospectively, and it lacks standardization. Federico Stella, MD, University of Milan, Milan, Italy presents the final analysis of the Neutrodiet trial; a multicenter, randomized trial that compared the infection rates, feeding outcomes, and acute graft-versus-host disease (aGvHD) incidence of non-restrictive diet (NRD) versus PD in autologous and allogeneic HSCT recipients. Overall, the study found no significant difference in these three metrics between the PD and NRD. Infections of grade 2 and above occurred in 34% of patients assigned to PD and in 39% of patients assigned to NRD. Both arms also had a similar incidence of fever of unknown origin, as well as a similar incidence of sepsis. Furthermore, no difference in any grade aGvHD or intestinal aGvHD was observed between the arms, and no differences were found between arms in terms of body weight variations, incidence of nausea and mucositis, hospitalization length, and parenteral nutrition (PN) use. From an analysis of daily diaries from patients in both arms, NRD was found to be associated with higher satisfaction. Taken together, this study supports the idea that a restrictive diet is an unnecessary burden for patients. This press briefing took place at the 64th ASH Annual Meeting and Exposition congress in New Orleans, LA.

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