Providing adequate nutrition support is incredibly challenging for blood cancer patients, especially those undergoing intensive therapies. Treatment-related toxicities—such as severe mucositis (painful mouth ulcers), constant nausea, and impaired oral intake—frequently prevent patients from eating normally. We know that nutrition and the gut microbiome (the community of microbes living in the digestive tract) deeply impact immune function, antimicrobial resistance (AMR), and how well a patient responds to cancer treatments.

Historically, patients undergoing allogeneic hematopoietic stem cell transplantation (alloHSCT, or bone marrow transplants) were given intravenous nutrition (Parenteral Nutrition, or PN). However, this method can cause severe metabolic issues, requires dedicated central line access, increases sepsis risk, and severely disrupts the gut microbiome. While feeding via a nasogastric tube (Enteral Nutrition, or EN) may be a safer, more cost-effective alternative, high-quality clinical evidence is still lacking.