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The goal of this clinical trial is to have a successful engraftment in after bone transplantation. Acute leukemia patient of both sexes aged 2 to 18 years, who are transplant candidates, participate in this study. Primary hypothesis is Patients receiving SMOF LIPID will have better grafts than patients receiving intralipid. Also, complications after surgery and malnutrition will be less in this group.
Patients will be randomly divided into two groups: the intervention group (TPN based on SMOFLipid) and the control group (TPN based on IntraLipid). At baseline (before HSCT) and after obtaining informed consent and assent, blood samples will be collected to test for biochemical markers, including total cholesterol, TG, LDL, HDL, FBS, Alb, Na, K, Ph, Ca, Mg, CRP, IL-6, BUN, Cr, and CBC. Furthermore, data on nutritional intake (total energy and protein) and appetite status will be gathered. The primary outcomes are neutrophil and platelet engraftment, defined as >500 for neutrophils and >20,000 for platelets, respectively. The possibility of oral intake, as well as the achievement of oral + ONS and total oral nutrition alongside TPN duration, will be recorded. On days +15 and +30, biochemical and anthropometric markers will be collected again. Furthermore, clinical outcomes such as acute GVHD, cholestasis, bleeding, infections, hospitalization, and mortality will be reported.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| SMOF lipid | Experimental | The SMOF lipid is given to the patient as a fat component of total parenteral nutrition. |
|
| Intralipid | Active Comparator | intralipids |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| SMOF lipid | Dietary Supplement | The SMOF lipid is given to the patient as a fat component of total parenteral nutrition. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Engraftment | blood counts of Neutrophils and platelets | Within 35 days after transplantation |
| Measure | Description | Time Frame |
|---|---|---|
| 100-day survival rate | Determination and comparison of 100-day survival rate after transplantation in both groups | Within 100 days after transplantation |
| Incidence of infection | Determining and comparing the incidence of infection |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Zahra Vahdat Shariatpanahi, Professor | Contact | 0098-021-22357484 | nutritiondata@yahoo.com | |
| Zahra Vahdat Shariatpanahi, Professor | Contact | 09122138186 | nutritiondata@yahoo.com |
| Name | Affiliation | Role |
|---|---|---|
| Zahra Vahdat Shariatpanahi, Professor | School of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran | Recruiting | Tehran | Iran |
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| ID | Term |
|---|---|
| D007938 | Leukemia |
| ID | Term |
|---|---|
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
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| INTRALIPIDS | Dietary Supplement | The Intralipid will be given to the patient as fat component of total parenteral nutrition. |
|
| Within 30 days after transplant |
| Incidence of bleeding | Determining and comparing the incidence of bleeding | Within 30 days after transplantation |
| Hospitalization | Determining and comparing the duration of hospitalization in both groups | up to 7 weeks after transplantation |
| Mortality | incidence of mortality in hospital | up to 7 weeks after transplantation |
| MAC (mid arm circumference) | Determination and comparison of MAC in both groups | On days 15 and 30 after transplantation |
| Albumin | Determination and comparison of serum albumin | On days 15 and 30 after transplantation |
| Acute gastrointestinal complications | Determining and comparing the incidence of acute gastrointestinal complications (including acute GVHD, cholestasis) in both groups. | Up to 100 days after transplantation |
| Duration of parenteral nutrition | Determining and comparing the duration of using parenteral nutrition | during hospitalization, up to 7 weeks after transplantation |
| Weight | Determination and comparison of weight in both groups | On days 15 and 30 after transplantation |
| Blood sugar | Determination and comparison of blood sugar, | On days 15 and 30 after transplantation |
| Serum electrolytes | Determination and comparison of serum electrolytes | On days 15 and 30 after transplantation |
| Serum lipids | Determination and comparison of serum lipids | On days 15 and 30 after transplantation |
| Serum Interleukin 6 (IL-6) | Determination of serum interleukin 6 (IL-6) | On days 15 and 30 after transplantation |