AbstractBackgroundMaintaining a good nutritional status during the hematopoietic cell transplantation (HCT) procedure is challenging in the pediatric population.MethodsIn a multicentric retrospective study, we compared the outcome of nutritional status and HCT‐related parameters in 227 pediatric patients during and after HCT between 2005 and 2015. 112 patients received a gastrostomy before the start of HCT (GS group), and 115 did not receive a gastrostomy (NGS). Data collection was performed at HCT, 3, 6, and 12 months post‐HCT.ResultsAt time point of HCT the Standard Deviation Score (SDS) of weight was 0.17 in the NGS group, and 0.71 in the GS group (p = .01) Patients in the NGS group lost more weight during the first 3 months after HCT than patients in the GS group. At 12 months, patients in the NGS remained at a lower weight, while patients in the GS group slightly increased their weight.There were no differences between the groups in the incidence of acute graft‐versus‐host‐disease (GvHD), overall survival, and non‐relapse mortality. However, the number of febrile episodes requiring intravenous treatment with antibiotics, was higher in the GS group as compared to the NGS group, during the first 3 months post‐HCT (p < .001).ConclusionsOur results indicate that gastrostomy can be utilized in children undergoing HCT without any negative effects on mortality. Therefore, the use of a gastrostomy appears to be a safe option to maintain a good nutritional status during the HCT procedure.