Dietary concerns during stem cell transplant

Stem cell transplant patients are very susceptible to germs that could be transmitted from food and beverages.  In an effort to provide a more protected environment, stem cell transplant patients are placed on a special diet upon admission for the conditioning regimen.

The stem cell transplant diet restrictions continue until the patient’s ANC is greater than 500 for three consecutive days and if graft vs. host disease is not present. Our dietitian will discuss the specifics of this diet with you and will also provide some important, additional information regarding safe food handling practices.

Stem Cell Transplant Diet

The stem cell transplant diet is one in which specific foods have been excluded in an effort to reduce the risk of infection. Besides minimizing the risk of infection, the goals of this diet are to promote growth and prevent loss of lean body tissue by providing adequate but not excessive calories and/or protein. Milk products are initially allowed on the diet but may be restricted if diarrhea and vomiting occur.  No restaurant or fast food is allowed until adequate engraftment occurs.  Your doctor, nurse practitioner, or dietitian will inform you of when it is safe to have restaurant food.  These diet guidelines are temporary.  They will be changed as your child's body recovers from the transplant.

The special diet will be stopped when adequate engraftment occurs; however, it is a good idea to continue to use safe food handling and preparation even after the special diet restrictions have ended.  Tips to avoid food-borne sickness:

  • Do not leave meal trays sitting in patient rooms over 60 minutes without refrigeration or re-heating.
  • Proper refrigeration and heating is necessary for all food.
  • Follow food and safety guidelines.

Foods that are allowed and not allowed on a SCT diet

FOODS ALLOWED FOODS TO AVOID
Dairy Products
  • lactaid or Soy milk
  • all pasteurized milk and milk products allowed provided no significant GI symptoms
  • soft-serve ice cream
  • raw milk
  • non-pasteurized dairy products
  • moldy cheeses, soft cheeses and cheese with a rind (bleu and brie)
Supplements/Formula
  • any canned or packaged supplement, e.g., Pediasure, Resource  Breeze, Ensure, Ensure Plus, etc
  • lactose free infant formulas: Lacto Free, All Soy, Isomil, Prosobee, Similac Sensitive
 
Soups
  • all canned or individual serving cans of water based soups and stews
  • cream based soups as tolerated
  • cold soups such as Gazpacho
Meat and Protein Products
  • all well-cooked meats including, beef, poultry, pork, and fish
  • all cooked eggs
  • any meat casserole cooked to at least 165o
  • processed lunch meats
  • peanut butter, soy products, beans or legumes
  • roasted nuts in individual packages
  • raw or undercooked meats or seafood
  • raw or undercooked eggs including yolk, Eggnog (unless pasteurized)
  • unroasted or raw nuts
Breads, Cereals and Other Starches
  • all breads, English muffins, bagels, hot dog and hamburger buns, rolls; sweet rolls, donuts, French toast, pancakes, biscuits, waffles
  • hot cereals including oatmeal, grits, cream of wheat, instant oatmeal; all dry cereals except those listed
  • all pasta (macaroni, spaghetti, egg noodles, etc)
  • all rice
  • cooked potatoes, instant potatoes, freshly cooked French fries
  • potato chips, corn chips, crackers, tortilla chips all from single serving packages
  • sweet rolls with cream or custard filling
  • unprocessed bran
  • cold and hot cereals with dried fruits, nuts or coconut added after cooking
  • any raw potato
Fruits and Juices
  • all canned fruits or fruit juices
  • cooked fresh fruits
  • unblemished, washed and peeled bananas, oranges, melons, and grapefruit without visible mold
  • all other fresh fruits or juices
  • no dried fruits (raisins, unless cooked with food)
  • no frozen fruit
Vegetables
  • cooked vegetables (fresh or frozen)
  • canned vegetables
  • canned vegetable juices (i.e., V8 juice)
  • canned or bottled salsa
  • raw or undercooked vegetables (salads)
  • raw vegetable juices
  • raw or uncooked salsa
Fats
  • individual serving margarine, butter
  • salad dressings, or vegetable oils
  • cooked gravy
  • peanut butter
  • bleu cheese dressing
Beverages
  • carbonated drinks in individual cans or bottles
  • tea, kool-aid, canned fruit drinks, water, carbonated flavored water, Gatorade, lemonade
  • avoid milk drinks if demonstrates symptoms of intolerance
  • freshly squeezed juices
Sweet and Spices
  • all fresh/dry spices, herbs and seasonings may be used in the cooking process
  • sugar
  • jam, jelly preserves from single serving packages
  • individual serving packages of ketchup, mayonnaise, relish, lemon juice, salad dressings, jelly, pasteurized honey, syrup, brown sugar, sugar, salt, canned chocolate syrup, dill pickles, black olives
  • chocolate and cocoa
  • cookies, candies, cakes, pies and ice cream made without uncooked fruit, fruit toppings or raw nuts
  • condiments from multi-serving container
  • pepper, green olives; dry/fresh spices and herbs added after cooking
  • herbal “health food store” supplements
  • shredded coconut
  • any cookies, candies, cakes, pies, ice cream made with uncooked fruit, fruit toppings or raw nuts