Neutropenic Diet Does Not Protect Leukemia Patients Undergoing Induction Therapy

NEW YORK NOV 19, 2008 (Reuters Health) - The results of a study published in the current issue of the Journal of Clinical Oncology suggest that a neutropenic diet does not prevent major infection or death in patients undergoing remission induction therapy for acute myeloid leukemia.

"Neutropenic diets are frequently used to prevent infection in patients with acute myeloid leukemia (AML)," Dr. Elihu Estey, of the University of Washington Medical Center, Seattle, and colleagues note. "Although such a diet potentially entails inconvenience, its value is uncertain."

To investigate, the researchers examined the benefits of a neutropenic diet in 153 patients with untreated AML or high-risk myelodysplastic syndrome (MDS) admitted to a high-efficiency particulate air-filtered room to receive chemotherapy. The patients were randomly assigned to a diet that contained no raw fruits or vegetables (cooked diet) or to a diet that contained fresh fruits and vegetables (raw diet).

All of the patients received antibacterial and antifungal prophylaxis, and remained on study until they were discharged to the outpatient setting. The main outcome measures were major infection (pneumonia, bacteremia, or fungemia) and death.

The groups were similar in terms of age, early risk of mortality score, chemotherapy received, and days at risk.

Overall, 29% of patients in the cooked-diet group and 35% of those in the raw-diet group developed a major infection, a nonsignificant difference. The time to major infection was similar in the groups. A fever of unknown origin was observed in 51% and 36% of patients in the cooked- and raw-diet groups, respectively.

"There was no suggestion that patients randomly assigned to the cooked group lived longer than those assigned to the raw group," Dr. Estey and colleagues write. Survival rates did not differ significantly and were as expected in newly diagnosed AML and MDS patients, and response rates were similar at 56% in the cooked-diet group and 61% in raw-diet group.

SOURCE:J Clin Oncol 2008;26.


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