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The Neutropenic diet
Patients who have undergone a Stem Cell Transplant will have lowered blood
counts for a period of time after their transplant recovery. This period of time
varies from patient to patient.
Allogeneic
transplant patients will take as much as twice as long as
Autologous
transplant patients to recover full immune function.
During this period of reduced immune function there will be much lower than
normal neutrophil counts. Neutrophils are the primary infection fighting white
blood cells. Patients must do everything they can to avoid unnecessary exposure
to bacteria in order to avoid overwhelming the immune system. This means strict
dietary rules to follow.
The Neutropenic diet
shown below seeks to reduce the amount of food introduced into the body that has
high levels of bacteria. While there are many good bacteria in our food there
are also many bad bacteria. Healthy people have immune systems that can easily
deal with the bad bacteria, but such is not the case for those with reduce
immune function.
Below is a guide to foods that are allowed, and those that you should avoid
during this period to reduce your risk of bad bacteria.
- Allogeneic patients should follow this for about 4-6
months post transplant
- Autologous patients should follow this for 1-3 months post
transplant
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FOOD GROUPS
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ALLOWED
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NOT ALLOWED
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Dairy
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All pasteurized, grade "A" milk and milk
products.
Commercially-packaged cheese and cheese
products made with pasteurized milk (i.e. mild and medium cheddar,
mozzarella, parmesan, Swiss, etc.)
Pasteurized yogurt
Dry, refrigerated, and frozen pasteurized
whipped topping
Ice cream, frozen yogurt, sherbet, ice
cream bars, homemade milkshakes
Commercial nutritional supplements and
baby formulas, liquid and powdered
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Unpasteurized or raw milk, cheese, yogurt,
and other milk products
Cheeses from delicatessens
Cheeses containing chili peppers or other
uncooked vegetables
Cheese with molds (i.e. blue, Stilton,
Roquefort, gorgonzola)
Sharp cheddar, brie, camembert, feta
cheese, farmer's cheese
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Vegetables
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All cooked frozen or canned vegetables.
All cooked herbs and spices (add at least
5 minutes before end of cooking)
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Raw vegetables, salads
Caesar Salads with Caesar dressing
Pepper
Garnishes
Uncooked herbs and spices
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Fruits and Nuts
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Canned and frozen fruit and fruit juices
Thick skinned fruits (oranges, bananas)
Melons cut up and used immediately
Canned or bottled roasted nuts
Nuts in baked products
Commercially packaged peanut butter
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Dried fruits
Raw fruit; foods containing raw fruits
Unpasteurized fruit and vegetable juices
Raw nuts
Roasted nuts in the shell
Precut fresh fruits
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Bread, Grain, and Cereal Products
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All breads, bagels, rolls, pan-cakes,
sweet rolls, waffles, French toast
Potato chips, corn chips, tortilla chips,
pretzels, popcorn
Cooked pasta, rice, and other grain
All cereals, cooked and ready-to-eat
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Raw grain products
Bakery breads, cakes, donuts, muffins
Potato/macaroni salad
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Entrees, Soups
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All cooked entrees and soups
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All miso products (i.e. miso soup)
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Meat and Meat Substitutes
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All well-cooked or canned meats (beef,
pork, lamb, poultry, fish, shellfish, game, ham, bacon, sausage, hot
dogs)
Well-cooked eggs (white cooked firm with
thickened yolk acceptable, i.e. hard boiled, over hard)
Pasteurized egg substitutes (i.e. Egg
Beaters)
Commercially-packaged salami, bologna, and
other luncheon meats
Canned and commercially-packaged hard
smoked fish, refrigerated after opening
Cooked tofu (which must be cut into 1"
cubes or smaller and boiled a minimum of five minutes in water or broth
before eating or using in recipes)
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Raw or undercooked meat,, poultry, fish,
game, tofu
Meats and cold cuts from delicatessen
Hard cured salami in natural wrap
Cold smoked salmon, lox
Pickled fish
Tempe (tempeh) products
Sushi
Raw oysters/clams
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Beverages
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Tap water
Commercial bottled distilled and natural
waters
All canned, bottled, powdered beverages
Instant and brewed coffee, tea; cold
brewed tea made with boiling water
Brewed herbal teas using
commercially-packaged tea bags
Commercial nutritional supplements, liquid
and powdered
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Well water (unless tested yearly and found
safe)
Cold-brewed tea made with warm or cold
water sun tea
Egg nog
Fresh apple cider
Homemade lemonade
Spring water
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Fats
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Oil, shortening
Refrigerated lard, margarine, butter
Commercial shelf-stable mayonnaise and
salad dressings (including cheese-based salad dressings, refrigerated
after opening)
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Fresh salad dressings containing aged
cheese (i.e. blue, Roquefort) or raw eggs, stored in refrigerated case
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Desserts
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Refrigerated commercial and homemade
cakes, pies, pastries, and pudding
Refrigerated cream-filled pastries
Homemade and commercial cookies
Shelf-stable cream-filled cupcakes (i.e.
Twinkies, Ding Dong), fruit pies (i.e. Poptarts, Hostess frit pies), and
canned pudding
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Unrefrigerated cream-filled pastry
products (not shelf-stable)
Cream or custard filled donuts
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Other
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Salt, granulated sugar, brown sugar
Jam, jelly, syrups (refrigerated after
opening)
Commercially-packaged (pasteurized) honey
Catsup, mustard, BBQ sauce, soy sauce,
other condiments (refrigerated after opening)
Pickles, pickle relish, olives
(refrigerated after opening)
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Raw or unpasteurized honey
Herbal and non-traditional (health food
store) nutritional supplements, Chinese herbs
Brewers yeast, if eaten uncooked
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