• Assessment
    Are the protein requirements of patients with hematological malignancies undergoing hematopoietic cell transplant different than the RDA?
    • Conclusion
      Three studies (one neutral quality timeseries, one positive quality RCT, and one negative quality longitudinal study) assessed the protein requirements of patients undergoing HCT in order to maintain positive nitrogen balance in the post-transplant period. Although studies assess the needs of patients with hematological malignancies, the type of transplant varies within and among studies. T wo of these studies did not reach nitrogen balance with protein intakes of 1.2 g protein per kg to 1.7 g protein per kg. The one study that did reach nitrogen balance provided 2.2 g protein per kg. Although these studies indicate that the needs of patients undergoing HCT are higher than the RDA, more research is needed to identify more defined recommendations for actual grams of protein required. The patients in the above mentioned studies received myeloablative HCT regimens. More recently non-myeloablative HCT has begun to replace this earlier form of HCT. The protein needs of patients may be different with non-myeloablative HCT.
    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: Protein Needs vs. RDA: HCT 2006
       
    Are the protein requirements of patients with solid malignancies undergoing hematopoietic cell transplant different than the RDA?
    • Conclusion
      One positive quality RCT assessed the protein requirements of patients undergoing HCT in order to maintain positive nitrogen balance in the post-transplant period. Half of the patients in this study were able to achieve positive nitrogen balance with protein intakes of 156 g protein per day (25 g nitrogen per day). This study did not report protein in relation to body weight, thus it is difficult to interpret the results in terms of the RDA for protein. 
    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: Protein Needs vs. RDA: HCT 2006