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Standardized parenteral alanyl-glutamine dipeptide supplementation is not beneficial in autologous transplant patients: a randomized, double-blind, placebo controlled study.
Bone Marrow Transplant 2002; 30(12):953-61BM

Abstract

We conducted a controlled, double-blind study of parenteral glutamine supplementation in an unselected group of consecutive autologous transplant patients. Patients received 30 g of alanyl-glutamine dipeptide (Dipeptiven; Fresenius-Kabi, Bad Homburg, Germany) or glutamine-free amino acid solution i.v. from day +1 to day +14 or to discharge. All patients were assessed for clinical status, mucositis, blood counts, oral intake and immune reconstitution. Parenteral nutrition was administered according to predefined guidelines. Forty patients were randomized; 21 into the glutamine and 19 into the placebo arm. Glutamine patients had less days with diarrhoea (3.3 +/- 4.0 vs 4.3 +/- 3.0, P = 0.03), but they had more severe oral mucositis (mean 4 +/- 4.7 vs 1.4 +/- 2.3 days of mucositis score >13, P = 0.04), spent more days on opioids (mean 3.5 +/- 4.2 vs 1.2 +/- 2.2 days, P = 0.03) and left hospital later than placebo patients (mean 13.5 +/- 3.1 vs 11.7 +/- 2.4 days after transplant, P = 0.06). There were more relapses (P = 0.02) and deaths (P = 0.05) in the glutamine group. The cost of supportive care (mean 2960 +/- 1694 vs 1534 +/- 513 Euro, P = 0.002) was also greater for glutamine patients, mainly due to the cost of glutamine dipeptide itself. The described mode and dosage of glutamine administration did not produce meaningful benefit in our autologous transplant patients and it was certainly not cost-effective.

Authors+Show Affiliations

Department of Clinical Haematology, University Hospital Královské Vinohrady, Prague, Czech Republic.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12476290

Citation

Pytlík, R, et al. "Standardized Parenteral Alanyl-glutamine Dipeptide Supplementation Is Not Beneficial in Autologous Transplant Patients: a Randomized, Double-blind, Placebo Controlled Study." Bone Marrow Transplantation, vol. 30, no. 12, 2002, pp. 953-61.
Pytlík R, Benes P, Patorková M, et al. Standardized parenteral alanyl-glutamine dipeptide supplementation is not beneficial in autologous transplant patients: a randomized, double-blind, placebo controlled study. Bone Marrow Transplant. 2002;30(12):953-61.
Pytlík, R., Benes, P., Patorková, M., Chocenská, E., Gregora, E., Procházka, B., & Kozák, T. (2002). Standardized parenteral alanyl-glutamine dipeptide supplementation is not beneficial in autologous transplant patients: a randomized, double-blind, placebo controlled study. Bone Marrow Transplantation, 30(12), pp. 953-61.
Pytlík R, et al. Standardized Parenteral Alanyl-glutamine Dipeptide Supplementation Is Not Beneficial in Autologous Transplant Patients: a Randomized, Double-blind, Placebo Controlled Study. Bone Marrow Transplant. 2002;30(12):953-61. PubMed PMID: 12476290.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Standardized parenteral alanyl-glutamine dipeptide supplementation is not beneficial in autologous transplant patients: a randomized, double-blind, placebo controlled study. AU - Pytlík,R, AU - Benes,P, AU - Patorková,M, AU - Chocenská,E, AU - Gregora,E, AU - Procházka,B, AU - Kozák,T, PY - 2002/01/23/received PY - 2002/07/25/accepted PY - 2002/12/12/pubmed PY - 2003/8/2/medline PY - 2002/12/12/entrez SP - 953 EP - 61 JF - Bone marrow transplantation JO - Bone Marrow Transplant. VL - 30 IS - 12 N2 - We conducted a controlled, double-blind study of parenteral glutamine supplementation in an unselected group of consecutive autologous transplant patients. Patients received 30 g of alanyl-glutamine dipeptide (Dipeptiven; Fresenius-Kabi, Bad Homburg, Germany) or glutamine-free amino acid solution i.v. from day +1 to day +14 or to discharge. All patients were assessed for clinical status, mucositis, blood counts, oral intake and immune reconstitution. Parenteral nutrition was administered according to predefined guidelines. Forty patients were randomized; 21 into the glutamine and 19 into the placebo arm. Glutamine patients had less days with diarrhoea (3.3 +/- 4.0 vs 4.3 +/- 3.0, P = 0.03), but they had more severe oral mucositis (mean 4 +/- 4.7 vs 1.4 +/- 2.3 days of mucositis score >13, P = 0.04), spent more days on opioids (mean 3.5 +/- 4.2 vs 1.2 +/- 2.2 days, P = 0.03) and left hospital later than placebo patients (mean 13.5 +/- 3.1 vs 11.7 +/- 2.4 days after transplant, P = 0.06). There were more relapses (P = 0.02) and deaths (P = 0.05) in the glutamine group. The cost of supportive care (mean 2960 +/- 1694 vs 1534 +/- 513 Euro, P = 0.002) was also greater for glutamine patients, mainly due to the cost of glutamine dipeptide itself. The described mode and dosage of glutamine administration did not produce meaningful benefit in our autologous transplant patients and it was certainly not cost-effective. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/12476290/Standardized_parenteral_alanyl_glutamine_dipeptide_supplementation_is_not_beneficial_in_autologous_transplant_patients:_a_randomized_double_blind_placebo_controlled_study_ L2 - http://dx.doi.org/10.1038/sj.bmt.1703759 DB - PRIME DP - Unbound Medicine ER -