Together We Can -- Newsletter of the Joan Karnell Cancer Center
 

Spring 2004

Caregivers: Giving and Getting the Care You Need
One Day at at Time
Neutropenia and Diet
Favorite Recipes
 
<< Back to JKCC home page
 

Neutropenia and Diet

In June 2001, the Joan Karnell Cancer Center at Pennsylvania Hospital received a grant from the Oncology Nursing Society to conduct a pilot study, “Effects of the Neutropenic Diet in the Outpatient Setting.” The following is a summary of the study and its results which concluded in December 2003.

During chemotherapy treatment, patients may experience a side effect known as neutropenia. Neutropenia is the severe drop in white blood cells – cells that protect the body against infection.

This condition can result in hospitalization or a delay in chemotherapy treatment, but patients can avoid neutropenia by reducing their exposure to bacteria and other agents that can cause infection. Exposure can also be reduced through diet. This neutropenic diet is based on avoiding raw fruit and vegetables since food carries outside bacteria.

While there is research on the diet’s effectiveness for inpatients receiving chemotherapy, outpatients were not studied.

Three questions were addressed for this study:

  • Are outpatients receiving chemotherapy able to comply with a neutropenic diet?
  • Is there a difference in the number of febrile (fever) admissions between compliant patients (patients who follow the diet) versus non-compliant patients (patients who do not follow the diet)?
  • Is there a difference in the number of positive blood cultures (indicating bacterial infections) between compliant versus non-compliant patients?

Patients between 18 and 70 years old, who were receiving outpatient chemotherapy at the Joan Karnell Cancer Center at Pennsylvania Hospital and Pennsylvania Oncology and Hematology Associates, were enrolled for 12 weeks. Patients were instructed on how to follow a neutropenic diet before starting their chemotherapy.

Follow-up calls were made to participants during weeks six and 12 of the study. The following are the study results:

Study Results

Are outpatients receiving chemotherapy able to comply with a neutropenic diet?

Of the 23 patients who completed the study, 16 patients (70 percent) were compliant with the diet.

Is there a difference in the number of febrile admissions between compliant versus noncompliant patients?

Of the 23 patients who completed the study, nine had hospital admissions or visits to the emergency room. However, only five of these admissions were for neutropenia (22 percent). Of the 16 compliant patients,who properly followed the diet guidelines, four (25 percent) were admitted for neutropenia. Of the seven non-compliant patients, only one was admitted for neutropenia.

Is there a difference in the number of positive blood cultures between compliant versus non-compliant patients?

Of the five patients admitted for neutropenia, four had positive blood cultures for gram negative rods (associated with food-borne bacteria). Of these four patients, only one patient had not followed the neutropenic diet.

In summary, about one-third of patients who participated in the study did not properly follow the neutropenic diet. However, following or not following the diet did not make a difference in fever-induced hospital admissions. In addition, there was no difference in bacterial blood infections in those who did or did not follow the diet.

The clinical significance in this pilot study is related to the time required for the diet education, content of diet education regarding food restrictions, and the difficulty patients have adhering to diet requirements given the number of side effects of chemotherapy. Future study is required in order to determine the best practice to improve outcomes for the treatment of neutropenia.

Special thanks to all the patients who participated. In addition, the Cancer Center would like to thank the Oncology Nursing Society and Amgen® for supporting this study.

 


appointment icon

Need an appointment? Request one online 24 hours/day, 7 days/week or call 800-789-PENN (7366) to speak to a referral counselor.

Related Links
Find a Cancer Specialist
Request an Appointment Online or call
800-789-PENN (7366)
Pennsylvania Hospital Visitor Information
Give Now to JKCC
 
JKCC Newsletter

-

Current Issue

-

Archive
RSS feed Newsletter RSS Feed
   
   

 

About Penn Medicine   Contact Us   Site Map   Privacy Statement   Legal Disclaimer   Terms of Use

Penn Medicine, Philadelphia, PA 800-789-PENN © 2014, The Trustees of the University of Pennsylvania space