Nutrition During Bone Marrow Transplant

Katrina Claghorn, RD
Last Modified: November 1, 2001

Dear OncoLink "Ask the Experts,"
I am a Staff Nurse doing a research project on nutrition and bone marrow transplant. I was wondering whether you had any up to date information inthis field. I am particularly interested in nutrition during the neutropenicstage.
I appreciate your assistance in this matter.
Thank you
M.W.

Katrina Claghorn, RD, Oncology Dietitian for the Abramson Cancer Center of the University of Pennsylvania, responds:

Until recently the diet for Bone Marrow Transplant (BMT) patients was very restrictive. This is due to the fact that BMT patients are at a very highrisk for neutropenia (a decrease of the white blood cell count and neutrophils) which makes them susceptible to multiple infections. The emphasis now is on food safety and sanitation. The focus isn't on "good" and "bad" foods but rather that all foods must be well cleaned and prepared following sanitary practices, and patients are instructed on theseguidelines. Also, patients are instructed on foods that are associated withfood borne pathogens (e.g. the need to cook meat until well done to avoid E.Coli). Most institutions allow only cooked and processed foods and restrict raw vegetables and fresh fruits (except for ones with thick peelable skins such as oranges and bananas).

Here at the Abramson Cancer Center of the University of Pennsylvania these guidelines are followed for autologous BMT patients as well as any patient who is neutropenic. Allogeneic BMT patients must follow a more restrictive form of the diet. They must also avoid aged cheeses, commercially prepared meat andvegetable salads, delicatessen foods, bakery products and freshly squeezed juices. However, it is important to note that the dietary guidelines are different at every institution and it is important to learn what restrictions your own medical team follows.