Comparison of the efficacy of medium chain triglycerides with long chain triglycerides in total parenteral nutrition in patients with hematologic malignancies undergoing peripheral blood stem cell transplantation

Background and aims: The purpose of this randomized study was to compare the efficacy of medium chain triglycerides (MCT) plus long chain triglycerides (LCT) with LCT alone in total parenteral nutrition (TPN) solutions in patients with various hematologic malignancies who underwent a hematopoietic peripheral blood stem cell (PBSC) transplantation. Methods: Of 36 patients entering into this study, 18 received MCT + LCT (group I) and the remaining 18 received LCT alone (group II) in TPN solutions. Patients were comparable regarding age, gender, donor-recipient gender, diagnosis, body weights, blood group differences and number of infused CD34+ cells/kg. Post - transplant parameters such as duration of platelet and neutrophil engraftment, coagulation parameters, number of days of febrile neutropenia and antibiotic administration, plasma glucose, triglyceride, cholesterol and albumin levels, graft-versus-host disease (GVHD) and first 100 day mortality were compared in both groups. Results: Median days of neutrophil > 0.5 x 10⁹/I and platelet of > 20 x 10⁹/I in group I and group II were 15 (range, 8-21), 11 (10-29) and 14 (range, 9-31), 13 (9-18) respectively (P>0.05). Median days of febrile neutropenia in group I and II were 10 (range, 4-23) and 7 (2-13) respectively (P=0.01). Median days of antibiotic administration in group I and II were 12 (range, 6-22) and 8 (4-25) respectively (P=0.04). Pre, peri- and post-transplant coagulation parameters such as PT, aPTT, and fibrinogen did not differ significantly between two groups (P>0.05), as well as plasma glucose, triglyceride, cholesterol, albumin levels, GVHD and first 100 day mortality. Conclusion: There was no difference between patients receiving MCT + LCT (group I) and LCTalone (group II) in TPN solutions regarding duration of engraftment and coagulation parameters, but numbers of median days of febrile neutropenia and days of antibiotic administration were significantly shorter in patients receiving LCTalone (group II) than those receiving MCT + LCT (P<0.01 and 0.04 respectively). (C) 2000 Harcourt Publishers Ltd.