PD244 - NUTRITIONAL MEDICAL THERAPY IN HEMATOLOGICAL PATIENTS ADMITTED TO THE ICU AFTER RECEIVING CAR-T CELL THERAPY

PD244

NUTRITIONAL MEDICAL THERAPY IN HEMATOLOGICAL PATIENTS ADMITTED TO THE ICU AFTER RECEIVING CAR-T CELL THERAPY

J. C. LOPEZ DELGADO^1,*, N. Urquia-Sanchez¹, L. Almorin-Gonzalvez¹, J. Moreno-Pazmiño², R. Gutierrez-Perez¹, E. Mayor-Vazquez¹, P. Doti¹, A. J. Balboa-Ortega³, P. Leyes-Garcia⁴, P. Castro-Rebollo¹ on behalf of N/A

¹Medical ICU, ²Hematology, Hospital Clínic de Barcelona, ³Bellvitge Research Institute, ⁴Nutrition Unit, Hospital Clínic de Barcelona, Barcelona, Spain

Rationale: Medical nutrition therapy(MNT) in critically ill with hematological malignancies has been poorly described. This study aims to analyze the clinical practice of MNT in patients admitted to the ICU who have received CAR-T cell therapy.

Methods: Retrospective observational study. Adult patients admitted to the ICU after receiving CAR-T cell therapy (February 2022 to July 2024) were included. Demographic data, comorbidities, prognostic and nutritional assessment indices, as well as complications, organ support needs, and laboratory parameters were analyzed. Statistical analysis was performed using SPSS 30.0.

Results: Thirty patients were included.66.7%(20) were male, mean age was 56.6±16 years, SOFA score 4(2–5) and APACHE score 12(10–17). The main cause for ICU admission was toxicity secondary to CAR-T (86.8%;n=26), requiring organ support in 23.3%(7)(16.6% respiratory support, 16.6% vasopressors, and 3.3% renal replacement therapy). 26.6%(8) died during hospitalization. MNT was performed in 40%(12): 13.3%(4) received enteral and/or parenteral nutrition, and 26.7%(8) received oral supplements along with oral diet. 33.3%(10) showed gastrointestinal complications. The incidence of nutritional risk varied considerably depending on the index that was calculated on ICU admission: 10.3% mNUTRIC, 26.67% NRS-2002, and 100% MNA. None of these proved to be a good predictor of the need for MNT(Figure). Albumin levels decreased significantly from the day of ICU admission to the day of hospital discharge. Patients who received MNT had a higher mean NRS-2002 score (2.61±1.1vs.3.5±1.1;P=0.02) and a longer mean ICU (5±6.3vs.14.8±17.2 days;P=0.02) and hospital (29.4±15vs.44.6±30.5 days;P=0.04) length of stays, with no differences observed in other clinical parameters.

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Conclusion: We did not show any clinical parameters or indices that can predict the need for TMN in these patients.

References: Clin Nutr ESPEN.2021;46:60-65. 

Disclosure of Interest: None declared