PhD Defence Rianne Henrica Maria Antonia van Lieshout

Keywords: Acute myeloid leukemia, Intensive treatment, Medical nutrition therapy, Body composition  
 

"Food for thought: Medical nutrition therapy in acute myeloid leukemia patients during intensive treatment"

Patients with acute myeloid leukemia (AML) receiving intensive chemotherapy often experience severe side effects that impair nutritional intake, putting them at high risk of malnutrition. Guidelines recommend early initiation of medical nutrition therapy (MNT)—including enteral and parenteral nutrition—when oral intake is insufficient. The primary goal of MNT should not only be to maintain body weight or fat mass, but also to preserve muscle mass. This thesis is the first to compare a proactive MNT strategy—where MNT is initiated as soon as a patient's nutritional intake becomes insufficient—with a wait-and-see approach, in which MNT is provided only in exceptional or severe cases. It also investigates barriers to implementing MNT guidelines and explores patients’ and health care professionals’ perceptions of different strategies.

Findings show that a proactive approach is associated with fewer nutrition impact symptoms and complications, shorter hospital stays, and better maintenance of body weight through better preservation of fat mass. Improved body composition was associated with better clinical and physical outcomes. These results informed a nutritional support pathway to guide shared decision-making and improve nutritional care for this population.

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