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The effect of high-dose enteral glutamine on the incidence and severity of mucositis in paediatric oncology patients.

Abstract

BACKGROUND/OBJECTIVE

The study was conducted to determine if enteral glutamine, 0.65 g kg(-1) daily for 7 days, is effective in reducing the incidence and severity of mucositis in paediatric oncology patients when given alongside chemotherapy. The study was carried out at St James's University Hospital, Leeds, UK.

SUBJECTS/METHODS

This was a randomized study using the patients as their own controls. Seventy-six patients undergoing treatment for paediatric malignancy having at least two identical courses of chemotherapy and at risk of developing mucositis participated in the study. Patients received one course of chemotherapy with glutamine and an identical course without. Alternate patients were allocated to have glutamine with course 1 or with course 2. The severity of symptoms of mucositis and the duration of enteral and parenteral nutrition were recorded. Daily ammonia levels were measured.

RESULTS

Fifty patients completed the study. No statistical significance with regard to symptoms of mucositis was found. Fewer children receiving glutamine required parenteral nutrition (P=0.049), and the duration of parenteral nutrition was less (P=0.023). No adverse effects attributed to taking the glutamine were observed.

CONCLUSIONS

The study showed that high-dose enteral glutamine did not reduce the incidence and severity of oral mucositis as determined by subjective toxicity measurements, but did show a significant reduction in parenteral nutrition usage. No adverse cumulative effect of this oral glutamine dose was observed.

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  • Authors+Show Affiliations

    ,

    Dietetic Department, St James's University Hospital, Leeds, UK. Evelyn.Ward@leedsth.nhs.uk

    , , , , , , ,

    Source

    MeSH

    Administration, Oral
    Adolescent
    Ammonia
    Antineoplastic Agents
    Child
    Child, Preschool
    Enteral Nutrition
    Female
    Gastrointestinal Tract
    Glutamine
    Humans
    Male
    Mucositis
    Neoplasms
    Parenteral Nutrition
    Young Adult

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    17728695

    Citation

    Ward, E, et al. "The Effect of High-dose Enteral Glutamine On the Incidence and Severity of Mucositis in Paediatric Oncology Patients." European Journal of Clinical Nutrition, vol. 63, no. 1, 2009, pp. 134-40.
    Ward E, Smith M, Henderson M, et al. The effect of high-dose enteral glutamine on the incidence and severity of mucositis in paediatric oncology patients. Eur J Clin Nutr. 2009;63(1):134-40.
    Ward, E., Smith, M., Henderson, M., Reid, U., Lewis, I., Kinsey, S., ... Picton, S. V. (2009). The effect of high-dose enteral glutamine on the incidence and severity of mucositis in paediatric oncology patients. European Journal of Clinical Nutrition, 63(1), pp. 134-40.
    Ward E, et al. The Effect of High-dose Enteral Glutamine On the Incidence and Severity of Mucositis in Paediatric Oncology Patients. Eur J Clin Nutr. 2009;63(1):134-40. PubMed PMID: 17728695.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The effect of high-dose enteral glutamine on the incidence and severity of mucositis in paediatric oncology patients. AU - Ward,E, AU - Smith,M, AU - Henderson,M, AU - Reid,U, AU - Lewis,I, AU - Kinsey,S, AU - Allgar,V, AU - Bowers,D, AU - Picton,S V, Y1 - 2007/08/29/ PY - 2007/8/31/pubmed PY - 2009/2/20/medline PY - 2007/8/31/entrez SP - 134 EP - 40 JF - European journal of clinical nutrition JO - Eur J Clin Nutr VL - 63 IS - 1 N2 - BACKGROUND/OBJECTIVE: The study was conducted to determine if enteral glutamine, 0.65 g kg(-1) daily for 7 days, is effective in reducing the incidence and severity of mucositis in paediatric oncology patients when given alongside chemotherapy. The study was carried out at St James's University Hospital, Leeds, UK. SUBJECTS/METHODS: This was a randomized study using the patients as their own controls. Seventy-six patients undergoing treatment for paediatric malignancy having at least two identical courses of chemotherapy and at risk of developing mucositis participated in the study. Patients received one course of chemotherapy with glutamine and an identical course without. Alternate patients were allocated to have glutamine with course 1 or with course 2. The severity of symptoms of mucositis and the duration of enteral and parenteral nutrition were recorded. Daily ammonia levels were measured. RESULTS: Fifty patients completed the study. No statistical significance with regard to symptoms of mucositis was found. Fewer children receiving glutamine required parenteral nutrition (P=0.049), and the duration of parenteral nutrition was less (P=0.023). No adverse effects attributed to taking the glutamine were observed. CONCLUSIONS: The study showed that high-dose enteral glutamine did not reduce the incidence and severity of oral mucositis as determined by subjective toxicity measurements, but did show a significant reduction in parenteral nutrition usage. No adverse cumulative effect of this oral glutamine dose was observed. SN - 1476-5640 UR - https://www.unboundmedicine.com/medline/citation/17728695/The_effect_of_high_dose_enteral_glutamine_on_the_incidence_and_severity_of_mucositis_in_paediatric_oncology_patients_ L2 - http://dx.doi.org/10.1038/sj.ejcn.1602894 DB - PRIME DP - Unbound Medicine ER -