The nutritional needs of a patient with a bone marrow transplant are best met with:

• A. 30-35 kcal/kg/day with >/= 1.5 g protein per kg body weight
• B. 20-35 kcal/kg daily with >/= 1.5 g protein per kg body weight
• C. 20-25 kcal/kg daily with 80% of total calories from carbohydrate
• D. 30-35 kcal/kg/day with 80% of total calories from carbohydrate

Answer: (A)

Bone marrow transplant patients undergo a hypermetabolic, catabolic state from conditioning, infection risk, and the healing process, so their nutritional plan needs extra energy and protein to support engraftment and recovery. Providing about 30-35 kcal per kilogram of body weight per day helps meet the increased energy demands, while at least 1.5 g of protein per kilogram supports tissue repair, immune function, and preservation of lean body mass.

A carbohydrate-heavy approach (for example, 80% of calories from carbohydrate) without adequate protein and total calories can compromise nitrogen balance and healing, and lower overall energy targets may leave the body underfed during this stressful period. Practical needs vary with tolerance, mucositis, infections, and graft-versus-host disease, so intakes are adjusted while monitoring weight and labs.