What should patients undergoing allogeneic hematopoietic stem cell transplantation pay attention to in their diet while in the sterile cabin? Can they eat fruit?

Author: Yan Xia, deputy chief nurse, Peking University People's Hospital

Reviewer: Ren Dajiang, deputy chief physician of the Seventh Medical Center of the General Hospital of the Chinese People's Liberation Army

Hematopoietic stem cell transplantation is a systematic project. Generally, patients undergoing allogeneic hematopoietic stem cell transplantation need to live in a sterile cabin, that is, a laminar flow clean ward.

During the time living in the laminar flow clean ward, there are actually no special requirements for diet. The best is what suits the patient's taste. Some like spicy food, some like sweet food, and the food can be adjusted according to the patient's taste, but it must be kept clean, fresh and hygienic.

Figure 1 Original copyright image, no permission to reprint

What does it mean to be clean, fresh and hygienic?

Don't buy frozen food, because you don't know how long it has been frozen, and there may be some corrosive bacteria in it, which may not be killed by high-pressure sterilization. To avoid this, try to eat fresh food, such as buying live fish.

In laminar flow clean rooms, all food must be sterilized again in a microwave oven or autoclave before it can be eaten by patients. Heating on high heat for five minutes can effectively achieve the sterilization effect. This is to prevent intestinal and systemic infections. In addition, the tableware used by patients must also meet specific requirements. Since microwave ovens are required for disinfection, iron tableware should be avoided and microwave-safe lunch boxes should be used.

Figure 2 Original copyright image, no permission to reprint

While in the laminar flow clean room, patients can take in appropriate condiments such as soy sauce, vinegar, pepper, and aniseed to promote the recovery of gastrointestinal function after discharge. Regarding pickles, patients can eat them, but they need to be fried first and heated in a microwave oven on high for five minutes. For fruits, cooked fruits should be selected and heated in a microwave oven on high for five minutes before being served to patients. However, some fermented foods, such as fermented tofu, are harmless to the human body because they contain yeast, but for patients undergoing allogeneic hematopoietic stem cell transplantation, their gastrointestinal tract may not be tolerated, so they should not be eaten.

During the stay in the laminar flow clean room, patients are advised to drink twice-boiled water, that is, pour the boiled water into a kettle and boil it again to ensure the water quality is safe. However, repeatedly boiling water may produce more water alkali, so boiled mineral water is currently more often consumed. In addition, if patients want to drink tea, they should avoid drinking too concentrated tea. Family members can brew it outside and then send it to the laminar flow clean room, and then heat it in a microwave oven on high heat for five minutes before drinking. At the same time, fresh fruit juice can also be selected as a drink, but it also needs to be heated in a microwave oven on high heat for five minutes before drinking.

During the stay in the laminar clean room, patients may have oral mucositis, and the diet needs to be adjusted according to the situation. If oral mucositis is very severe and normal food cannot be eaten, semi-liquid food, such as noodles, thick porridge, and less irritating and softer food can be eaten. Before eating, some mouthwash painkillers can be used to temporarily numb the mouth, so that it is easier to eat.

During the stay in the laminar flow clean room, family members can visit. There are two ways to visit in various hospitals. Some hospitals use the visiting corridor, which may be separated from the patient by one or two layers of glass. You can see the patient through the glass and hear the voice through the phone. Another way of visiting is called video intercom, which has a screen and you can talk to the family members on the screen.