Table 6. Nutritional recommendations in patients with Graft- versus -host disease.

Evaluate nutritional status by a specialist
Maintain energy requirements at 30 to 50 cal/kg, and protein requirements at 1.5-2g/kg
Monitor weight and nutrient intake in the first year after transplant; patients with active GVHD need longer monitoring
Advise and monitor nutritional support specifically for patients with GVHD of the gastrointestinal tract; initiate specialized nutritional support in patients with significant gastrointestinal tract dysfunction and anorexia, who are unable to maintain adequate body weight
Supplement with multivitamins/minerals (no iron due to the risk of hemochromatosis); other supplements, like vitamin C, zinc, folic acid, and omega 3 may be beneficial
Advise the patient on nutritional aspects regarding food safety and the risk of foodborne diseases during immunosuppression

Source: Adapted from Roberts S, Thompson J. Graft-vs-host disease: nutrition therapy in a challenging condition. Nutr Clin Pract. 2005;20(4):440-50. ⁽²⁹⁾ GVHD: Graft versus host disease.