Efficacy Of Oral Glutamine Supplementation For Prevention Of Mucositis Associated With Beam Conditioning In Bone Marrow Transplant


Affiliations

  • Investigator-Consulting Dietitian, India
  • HOD Medical Oncology BMT Physician, India
  • Associate Professor, India

Abstract

Objective: To Determine Whether Oral Glutamine Supplementation Reduces The Grade Of Oral Mucositis In Autologous Bmt With Beam Conditioning Chemotherapy. Methodology: 28 Consecutive Patients Of Autologous Transplant Receiving Beam Conditioning Are Equally Divided In 2 Groups 14 Patients In Each Group. Glutamine Supplementation Of 20g/day Dissolved In 200ml Water Was Given To The Study Group Patients Twice A Day From Post Transplant Day +1 To Day+23 And The Grading Of Oral Mucositis And Diarrhea For Both The Study And Control Groups Was Tabulated Daily According To Who Scale Of Grading For Oral Mucositis. Results: the Study And The Control Groups Were Clinically Similar. The Incidence Of Grade 2 4 Mucositis Is Significantly Less In The Study Group (p = 0.006). Diarrhea Wasn't Statistically Significant Between The Study And The Control Groups ( P =0.866). Conclusion: Patients Receiving Oral Glutamine Supplementation After Bone Marrow Transplant Had Significantly Lesser Grade Of Oral Mucositis And Related Morbidity.

Keywords

Glutamine, Beam, Mucositis, Autologous Bone Marrow Transplant

Full Text:

References

Anderson PM, Ramsay NRC, Rydholm N, Rogosheske J & Nicklow R (1998a) Use of low dose oral glutamine in painful stomatitis during bone marrow transplantation. Bone Marrow Transplantation 22,339344.

Anderson PM, Schroeder G & Skubitz KM (1998b) Oral glutamine reduces the duration and severity of stomatitis after cytotoxic cancer chemotherapy. Cancer 83,14331439.

Biron P, Sebban C, Gourmet R, Chvetzoff G, Philip I & Blay JY(2000) Research controversies in management of oral mucositis. Supportive Care in Cancer8,6871.

Blijlevens NM, Donnelly JP & De Pauw BE (2000) Mucosal barrier injury: biology, pathology, clinical counter parts and consequences of intensive treatment for haematological malignancy: an overview. Bone Marrow Transplantation 25,12691278.

Bozzetti F, Biganzoli L, Gavazzi C, Cappuzzo F, Carnaghi C,Buzzoni R, Dibartolomeo M &Baietta E (1997)

Glutamine supplementation in cancer patients receiving chemotherapy: a double blind randomized study. Nutrition 13,748751.

Brown SA, Goringe A, Fegan C, Davies SV, Giddings J &Whittaker JA (1998) Parenteral glutamine protects hepatic function during bone marrow transplantation. Bone Marrow Transplantation 22,281284.

Cockerham MB, Weinberger BB & Lerchie SB (2000) Oral glutamine for the prevention of oral mucositis associated with high-dose paditaxel and melphalan for autologous bone m arrow transplantation. Annals of Pharmacotherapy 34,300303.

Coghlin-Dickson TM, Wong RM, Negrin RS, Shizuru JA, Johnston LJ, Hu WW, Blume KG & Stockerl-Goldstein KE(2000) Effect of oral glutamine supplementation during bone

marrow transplantation. Journal of Parenteral and Enteral Nutrition 24, 6166.Daniele B, Perrone F, Gallo C, Pignata S, De Martino S, De Vivo

R, Barletta E, Tambaro R, Abbiati R & D'Agostino L (2001)0ral glutamine in the prevention of fluorouracil induced 12. intestinal toxicity: a double blind, placebo controlled, randomised trial. Gut 48,2833.

Darmaun D (2000) Role of glutamine depletion in severe illness. Diabetes, Nutrition and Metabolism 13,2530.

Jebb SA, Marcus R & Elia M (1995) A pilot study of oral glutamine supplementation in patients receiving bone marrow transplants.

Clinical Nutrition 14,162165.

Jebb SA, Osborne RJ, Maughant IS & Elia M (1994)5-Fluorouracil and folinic acid induced mucositis: no effect of oral glutamine supplementation. British Journal of Cancer 70,732735.

Jonas CR, Puckett AB, Jones DP, Griffith DP, Szeszycki EE, Bergman GF, Carlson JL, Newman MR, Galloway JR BIumberg JB & Ziegler TR (2000) Plasma antioxidant status after high dose chemotherapy: A randomized trial of parenteral nutrition in bone m arrow transplantation patients. America Journal of Clinical Nutrition 72,181189.

Muscaritoli M, Micozzi A, Conversano L, Martino P, Petti MC,Cartoni C, Cascino A & Rossi-Fanelli F (1997) Oral glutamine in the prevention of chemotherapy-induced gastrointestinal toxicity. European Journal of Cancer 33,319320.

Michalak JC & Pierson N (1999) Phase III controlled evaluation of glutamine for decreasing stomatitis in patients receiving fluorouracil (5-FU)-based chemotherapy. American Journal of Clinical Oncology 22, 258261.

Poynton CH, Maughan T & Elia M (1995) Glycyl L-glutamine reduces gut toxicity in bone marrow transplantation. Blood 86,586 (abstract).bone marrow transplantation: a double-blind, controlled study. Journal of Parenteral and Enteral Nutrition 23,117122.

Slavin S (2000) New strategies for bone marrow transplantation. Current Opinions in Immunology 12,542551.

Van Zaanen HCT, Van Der Lelie H, Timmer JG, Furst P&

Sauerwein HP (1994) Parenteral glutamine dipeptide supplementation does not ameliorate chemotherapy-induced toxicity. Cancer 74,28792884.

Wilmore DW, Schloerb PR & Ziegler TR (1999) Glutamine in the support of patients following bone marrow transplantation. Current Opinion in Clinical Nutrition and Metabolic Care 2,323327.

Ziegler TR, Bazargan N, Leader LM & Martindale RG (2000a)Glutamine and the gastrointestinal tract. Current Opinion in Clinical Nutrition and Metabolic Care 3, 355362.


Refbacks

  • There are currently no refbacks.