A neutropenic diet in haemato-oncological patients receiving high-dose therapy and hematopoietic stem cell transplantation : a systematic review

Background/Objectives: Although the benefits of low-germ diets for patients are increasingly being questioned, their application in practice is widespread. The aim of this review is to summarise the current data and evaluate the effectiveness of the neutropenic diet (ND) in adult haemato-oncological patients to provide a basis for practical guidelines. Methods: A systematic search was conducted in four electronic databases (Medline (Ovid), CINAHL (EBSCO), EMBASE (Ovid) and Cochrane CENTRAL) to identify English and German randomised controlled trials (RCTs) concerning the effectiveness of an ND in adult haematological patients. The main endpoints were fever and systemic infections, gastrointestinal (GI) infections, mortality, nutritional status and hospitalisation length. Results: A total of five RCTs with 510 adult patients were included in this systematic review. All patients received high-dose chemotherapy in order to treat haemato-oncological malignancies. None of the analysed endpoints showed a significant advantage of the ND compared to the control group. Conclusions: An ND does not have a beneficial effect on infection rates, GI health, mortality or hospitalisation length for haemato-oncological patients. On the contrary, an ND tends to negatively affect the patient’s nutritional status; therefore, an adaption in clinical routine should take place.