Basic dietary care
Patients with acute leukemia tend to have fever, anemia, decreased gastric acid secretion, and reduced appetite or even anorexia. Most of the patients are in poor health and have reduced food intake, which is very likely to have a negative nitrogen balance, lowering the patient’s immunity, causing or aggravating infections, and so on in a vicious circle.
Patients and their family members are advised to communicate closely with the dietitian, and to match food appropriately according to the patient’s actual condition, paying attention to comprehensive and balanced nutrition, focusing on light foods, avoiding foods that are fried, greasy, and thickly seasoned. The patient is encouraged to do appropriate activities before meals or take drugs to promote digestion to increase the patient’s appetite, and for patients who eat less each time are encouraged to eat more meals.
For comprehensive nutrition of patients, the main focus is on the following aspects:
Adequate protein supplementation
Patients with leukemia need to pay attention to protein supplementation because of increased metabolism during chemotherapy and increased protein intake and consumption due to various gastrointestinal adverse effects caused by chemotherapy drugs. In general, the daily protein requirement for leukemia patients is 1.2g per kg body mass, but patients with anemia and fever need to increase it appropriately, and it is recommended to consume high quality protein such as eggs, lean meat, milk, fish and other foods rich in essential amino acids.
Appropriate vitamin and micronutrient supplementation
Vitamins and minerals can regulate protein and energy metabolism and are also essential nutrients for cancer patients. As leukemia patients are in a high consumption and high metabolic state during chemotherapy, they tend to lose trace elements such as sodium, potassium, calcium and phosphorus, resulting in acid-base imbalance of body fluids. Fruits and fresh green leafy vegetables rich in B-vitamins and vitamin C. For patients with anemia, appropriate consumption of red dates, peanuts, black fungus, etc., is better for raising hemoglobin.
Appropriately drink more water during chemotherapy
Patients with leukemia need more water than usual during chemotherapy because they lose more water due to gastrointestinal reactions. The patient will benefit from drinking more water, not only to help the kidneys eliminate waste and toxins from the body, but also to prevent or reduce the stimulation of the urinary system by chemotherapy drugs and reduce the incidence of inflammatory reactions in the urinary tract. Generally speaking, patients need to drink 2-3L of water daily during chemotherapy to ensure that the urine volume is above 100ml/h. For patients who repeatedly vomit after eating or drinking, it is not advisable to force them to eat or drink, and their families should communicate with the medical staff in time to find the cause and treat accordingly.
Eating care during chemotherapy
Dietary care during the administration of menadione drugs
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In the treatment of acute lymphoblastic leukemia, menthylase analogs are important drugs for treatment, and their administration may increase the risk of digestive disorders such as pancreatitis, so patients are asked to eat a low-fat diet from the first few days of treatment with these drugs to about half a month after the end of treatment.
A “low-fat diet” means a diet low in fat, i.e., no fatty foods such as fatty meats, fried foods, some seafood, etc. It does not mean that you cannot eat meat, but rather that foods rich in high-quality protein such as lean meats, eggs, and low-fat milk are necessary in the diet. A long-term low-protein or even protein-free diet will lead to severe malnutrition and even edema, which will affect the overall treatment of the patient. It is advisable to choose steaming, boiling, or stir-frying with a small amount of vegetable oil in the cooking method.
Dietary care during hormonal drug application
Hormones are also an important drug in the treatment of leukemia, especially in lymphatic leukemia, where they are used intermittently throughout the treatment. The first thing you need to do is to make sure that you have a good understanding of what you are doing. However, parents must pay attention to their children’s stools, if the stool is constipated, defecation difficulties, must promptly communicate with the doctor. The company’s products and services are available in a wide range of sizes and sizes.
In addition, it is important for obese patients, especially those with a history or family history of diabetes or hypertension, to control their diet appropriately, especially when in maintenance treatment, when the patient is out of the hospital and away from the doctor, and when it is important for family members to regularly monitor the patient’s blood sugar and blood pressure to detect the onset of secondary diabetes and hypertension as early as possible. In addition, the long-term application of hormonal drugs is prone to calcium loss, and patients should pay attention to proper calcium supplementation and more sunlight to minimize the occurrence of serious complications such as femoral head necrosis caused by calcium deficiency.
Dietary care during mercaptopurine administration
Mercaptopurine is a major drug in the treatment of acute lymphoblastic leukemia and dominates maintenance therapy. Because of its pharmacologic profile, mercaptopurine should be taken on an empty stomach before bedtime, and patients should be careful not to eat for half an hour before or after taking the drug to achieve optimal absorption of the drug.
Dietary care during the occurrence of chemotherapy-related complications
Dietary care for patients with nausea and vomiting
As chemotherapy progresses and the cumulative dose of drugs gradually increases, some patients may experience nausea and vomiting, and the timing of the patient’s meals can be adjusted appropriately.
Eat a light diet and drink plenty of water as appropriate. Do not consume both cold and hot foods, and it is best to consume warm foods to avoid uncomfortable sensations such as digestive discomfort and dental allergies. For patients with heavy gastrointestinal reactions, frequent vomiting, and bile that can be vomited out, the patient has no appetite at all and cannot be forced to eat. The actual fact is that you will be able to get a lot more than just a few of these.
Care of patients with gastrointestinal mucosal bleeding
Patients with leukemia have an increased brittleness of the blood vessel wall due to infiltration of leukemia cells, and an increased tendency to bleed due to a decrease in platelets, which can lead to gastric mucosal tearing and bleeding of the gastrointestinal mucosa when vomiting is severe. For these patients, a slightly cooler semi-liquid or liquid diet is appropriate, avoiding harder, rougher, more irritating or barbed foods, such as chili peppers and vinegar, to avoid irritating the GI mucosa and causing GI bleeding that could endanger the patient’s life.
Dietary care for patients with diarrhea
Most antitumor drugs are anti-cell cycle metabolites, and because of the vigorous proliferation of the gastrointestinal epithelium, which is also subject to certain inhibitory effects, the intestinal mucosa becomes edematous, congested, and ulcerated, causing the patient to develop diarrhea. For such patients, while taking antidiarrheal agents as prescribed by the doctor, we recommend that they eat foods with low fiber content and avoid excessive fats and sweets. Avoid gas-producing items such as cabbage, beans, carbonated beverages, etc. If the diarrhea is severe, a light diet such as clear broth, strained rice broth, vegetable juice and fruit juice should be considered.
Dietary care for patients with mouth ulcers
Chemotherapy drugs not only kill leukemia cells, but also destroy some of the patient’s own inherently healthy cells. When the patient’s salivary gland secretion is suppressed, it causes changes in the amount and composition of saliva, so the patient is prone to oral disease. Patients may develop oral ulcers, pain, etc. At this time, the patient’s white blood cells are significantly reduced, resistance is reduced, if given food that damages the oral mucosa, it can aggravate the ulcers and even cause infection.
Family members should give the patient a soft or liquid, highly nutritious, vitamin-rich diet and avoid foods that are too hot, rough, raw, acidic, or irritating. Patients should rinse their mouths with sodium bicarbonate mouthwash to clean their mouths before and after eating.
Enhance oral care
Chemotherapy drugs not only kill leukemia cells, but also destroy some of the patient’s own inherently healthy cells the body’s resistance is reduced. Salivary gland secretion is inhibited, causing patients to have changes in saliva volume and
Changes in composition, so it is easy to develop oral diseases such as gingivitis, dry mouth, and mycosis fungoides. If there is bad breath, there is no appetite. Patients can be allowed to gargle with 5 % baking soda, Dobell’s solution and 3 % hydrogen peroxide to moisten the mucous membrane, cleanse the mouth, eliminate bad breath, and promote appetite.
Dietary care for patients with hypoplastic platelets
Do not eat foods that are too hard, pointed, or spiky.
Dietary care for patients with low blood count
The patient’s diet should be careful to prevent bleeding and infection. The family can give the patient a high-pressure sterile diet and do not eat excessively hard, pointed, or spiky foods. Pay attention to food combination to prevent diarrhea, such as yogurt should not be eaten with fruit. Fruits are best to choose those that can be peeled and easily washed, such as apples and bananas. Do not eat strawberries, grapes and frozen foods that have been left for a long time, etc. to avoid digestive tract infections.
Dietary contraindications for children with leukemia
The question of whether children with blood disorders need to avoid eating cannot be generalized.
From a TCM perspective, it is important to follow the principles of yin and yang, cold and heat, and the five elements. However, it is not recommended to give children a lot of nourishing herbs, such as ginseng, wolfberry and aconite.
From a Western medicine point of view, any food that is nutritious, clean and hygienic and does not have harmful effects on the body can be used as a diet for children.
Generally speaking, cold, greasy foods are best avoided. The first thing you need to do is to make sure that you have a good idea of what you are doing. Children with mouth ulcers or gastrointestinal bleeding should not eat a stimulating, spicy or hot diet. It is important to note that children who have had allergic reactions to certain foods (such as seafood) in the past, parents are careful not to allow their children to eat such foods.