Abstract：
OBJECTIVE: For children and adolescents undergoing hematopoietic stem cell transplant (HSCT), adequate protein and energy intake is essential to mitigate malnutrition risk. However, little is known about optimal requirements, including adequate dietary protein intake in this population. We conducted an international benchmarking survey and a scoping review to explore current practices in determining protein requirements (PR) and examine existing evidence for PR and dietary protein intake in pediatric HSCT.
METHODS: Twelve pediatric oncology centers were surveyed to elicit current practices in determining PR in pediatric HSCT. A scoping review then collected sources of evidence from six databases (MEDLINE, Embase, CINAHL, PubMed, Cochrane Library and Web of Science) and grey literature (Google Scholar).
RESULTS: Survey data revealed variable practices in determining PR for pediatric HSCT patients. Four centers (44%) used the American Society for Parenteral and Enteral Nutrition (ASPEN) Nutrition Support in Pediatric Critically Ill Patient Guidelines 2009 and four (44%) used local guidelines or their national nutrient reference values (NRV). The scoping review included nineteen studies. The review highlighted a broad range of PR used in this population, ranging from 0.8 to 3.0 g/kg/d. Practices regarding the documentation and frequency of collecting protein intake data varied. Only five studies reported estimated protein requirement (EPR) status and just two studies met EPR. No clinical guidelines on PR in pediatric HSCT were identified.
CONCLUSIONS: Given the existing gap in evidence, the optimal amount of protein required for children and adolescents undergoing HSCT remains unknown. To establish specific, evidence-based PR guidelines, comprehensive research is needed. Future investigations should prioritize evaluating current clinical practices, assessing the gap between actual protein intake and EPR, and understanding the relationship between protein intake, protein status, and the impact on treatment outcomes. Addressing these research priorities is crucial for bridging the current evidence gap, thereby enabling the development of enhanced and personalized nutritional support for children and adolescents undergoing HSCT.
METHODS: Twelve pediatric oncology centers were surveyed to elicit current practices in determining PR in pediatric HSCT. A scoping review then collected sources of evidence from six databases (MEDLINE, Embase, CINAHL, PubMed, Cochrane Library and Web of Science) and grey literature (Google Scholar).
RESULTS: Survey data revealed variable practices in determining PR for pediatric HSCT patients. Four centers (44%) used the American Society for Parenteral and Enteral Nutrition (ASPEN) Nutrition Support in Pediatric Critically Ill Patient Guidelines 2009 and four (44%) used local guidelines or their national nutrient reference values (NRV). The scoping review included nineteen studies. The review highlighted a broad range of PR used in this population, ranging from 0.8 to 3.0 g/kg/d. Practices regarding the documentation and frequency of collecting protein intake data varied. Only five studies reported estimated protein requirement (EPR) status and just two studies met EPR. No clinical guidelines on PR in pediatric HSCT were identified.
CONCLUSIONS: Given the existing gap in evidence, the optimal amount of protein required for children and adolescents undergoing HSCT remains unknown. To establish specific, evidence-based PR guidelines, comprehensive research is needed. Future investigations should prioritize evaluating current clinical practices, assessing the gap between actual protein intake and EPR, and understanding the relationship between protein intake, protein status, and the impact on treatment outcomes. Addressing these research priorities is crucial for bridging the current evidence gap, thereby enabling the development of enhanced and personalized nutritional support for children and adolescents undergoing HSCT.
摘要：
目的：对于接受造血干细胞移植（HSCT）的儿童和青少年，充足的蛋白质和能量摄入对于减轻营养不良风险至关重要.然而,对最优需求知之甚少，包括该人群充足的膳食蛋白质摄入量。我们进行了一项国际基准调查和范围审查，以探索确定蛋白质需求（PR）的现行做法，并检查儿科HSCT中PR和饮食蛋白质摄入量的现有证据。
方法：对12个儿科肿瘤中心进行了调查，以得出目前在确定儿科HSCT中PR的做法。范围审查然后从六个数据库(MEDLINE，Embase,CINAHL,PubMed,Cochrane图书馆和WebofScience)和灰色文献(谷歌学者)。
结果：调查数据揭示了在确定儿童HSCT患者PR时的各种实践。四个中心（44％）在2009年儿科危重病患者指南中使用了美国肠外和肠内营养学会（ASPEN）营养支持，四个中心（44％）使用了当地指南或其国家营养参考值（NRV）。范围审查包括19项研究。该评论强调了该人群中使用的广泛PR，范围从0.8到3.0g/kg/d。关于收集蛋白质摄入量数据的记录和频率的做法各不相同。只有五项研究报告了估计的蛋白质需求（EPR）状态，只有两项研究符合EPR。没有确定儿童HSCT中PR的临床指南。
结论：鉴于现有的证据差距，接受HSCT的儿童和青少年所需蛋白质的最佳量仍未知.建立具体的，基于证据的公关指南，需要进行全面的研究。未来的调查应优先评估当前的临床实践，评估实际蛋白质摄入量和EPR之间的差距，了解蛋白质摄入之间的关系，蛋白质状态，以及对治疗结果的影响。解决这些研究重点对于弥合当前的证据差距至关重要，从而为接受HSCT的儿童和青少年提供增强和个性化的营养支持。
方法：对12个儿科肿瘤中心进行了调查，以得出目前在确定儿科HSCT中PR的做法。范围审查然后从六个数据库(MEDLINE，Embase,CINAHL,PubMed,Cochrane图书馆和WebofScience)和灰色文献(谷歌学者)。
结果：调查数据揭示了在确定儿童HSCT患者PR时的各种实践。四个中心（44％）在2009年儿科危重病患者指南中使用了美国肠外和肠内营养学会（ASPEN）营养支持，四个中心（44％）使用了当地指南或其国家营养参考值（NRV）。范围审查包括19项研究。该评论强调了该人群中使用的广泛PR，范围从0.8到3.0g/kg/d。关于收集蛋白质摄入量数据的记录和频率的做法各不相同。只有五项研究报告了估计的蛋白质需求（EPR）状态，只有两项研究符合EPR。没有确定儿童HSCT中PR的临床指南。
结论：鉴于现有的证据差距，接受HSCT的儿童和青少年所需蛋白质的最佳量仍未知.建立具体的，基于证据的公关指南，需要进行全面的研究。未来的调查应优先评估当前的临床实践，评估实际蛋白质摄入量和EPR之间的差距，了解蛋白质摄入之间的关系，蛋白质状态，以及对治疗结果的影响。解决这些研究重点对于弥合当前的证据差距至关重要，从而为接受HSCT的儿童和青少年提供增强和个性化的营养支持。
