Tags

Type your tag names separated by a space and hit enter

Effect of low-dose oral glutamine on painful stomatitis during bone marrow transplantation.

Abstract

Painful oral mucositis is a common complication after bone marrow transplantation (BMT). Glutamine is a nutrient for rapidly dividing cells and the major energy source for intestinal epithelium. This study tested whether an oral glutamine preparation could decrease the severity of oral mucositis in patients undergoing BMT. Glutamine or a placebo (glycine) were administered from admission until day +28 in 193 BMT patients in a randomized, double-blind, placebo-controlled study at a dose of 1.0 g amino acid/m2/dose swish and swallow four times a day. In autologous BMT patients (n = 87) glutamine was associated with significantly less mouth pain by self report and by opiate use (5.0+/-6.2 days of morphine for glutamine vs 10.3+/-9.8 days for placebo; P= 0.005). Matched sibling BMT patients had no effect by self report and an increased duration of opiate use (23.2+/-5.7 days for glutamine vs 16.3+/-8.3 days for placebo) (P = 0.002). However, day 28 survival of allogeneic patients was improved by glutamine. No significant differences in TPN use, rate of relapse or progression of malignancy, parenteral antibiotic use, acute or chronic GVHD, or days of hospitalization were observed in either autologous or allogeneic recipients. No toxicity of glutamine was observed. We conclude that oral glutamine can decrease the severity and duration of oropharyngeal mucositis in autologous BMT patients but not in allogeneic BMT patients, possibly due to interaction with methotrexate.

Links

  • FREE Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Pediatrics, University of Minnesota Medical School, Minneapolis, USA.

    , , , , , ,

    Source

    Bone marrow transplantation 22:4 1998 Aug pg 339-44

    MeSH

    Administration, Oral
    Adolescent
    Adult
    Analgesics, Opioid
    Bone Marrow Transplantation
    Child
    Child, Preschool
    Disease-Free Survival
    Double-Blind Method
    Female
    Glutamine
    Graft vs Host Disease
    Humans
    Infant
    Infant, Newborn
    Male
    Middle Aged
    Morphine
    Mouth Mucosa
    Mouthwashes
    Parenteral Nutrition, Total
    Stomatitis
    Treatment Outcome

    Pub Type(s)

    Clinical Trial
    Journal Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    9722068

    Citation

    Anderson, P M., et al. "Effect of Low-dose Oral Glutamine On Painful Stomatitis During Bone Marrow Transplantation." Bone Marrow Transplantation, vol. 22, no. 4, 1998, pp. 339-44.
    Anderson PM, Ramsay NK, Shu XO, et al. Effect of low-dose oral glutamine on painful stomatitis during bone marrow transplantation. Bone Marrow Transplant. 1998;22(4):339-44.
    Anderson, P. M., Ramsay, N. K., Shu, X. O., Rydholm, N., Rogosheske, J., Nicklow, R., ... Skubitz, K. M. (1998). Effect of low-dose oral glutamine on painful stomatitis during bone marrow transplantation. Bone Marrow Transplantation, 22(4), pp. 339-44.
    Anderson PM, et al. Effect of Low-dose Oral Glutamine On Painful Stomatitis During Bone Marrow Transplantation. Bone Marrow Transplant. 1998;22(4):339-44. PubMed PMID: 9722068.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effect of low-dose oral glutamine on painful stomatitis during bone marrow transplantation. AU - Anderson,P M, AU - Ramsay,N K, AU - Shu,X O, AU - Rydholm,N, AU - Rogosheske,J, AU - Nicklow,R, AU - Weisdorf,D J, AU - Skubitz,K M, PY - 1998/8/29/pubmed PY - 1998/8/29/medline PY - 1998/8/29/entrez SP - 339 EP - 44 JF - Bone marrow transplantation JO - Bone Marrow Transplant. VL - 22 IS - 4 N2 - Painful oral mucositis is a common complication after bone marrow transplantation (BMT). Glutamine is a nutrient for rapidly dividing cells and the major energy source for intestinal epithelium. This study tested whether an oral glutamine preparation could decrease the severity of oral mucositis in patients undergoing BMT. Glutamine or a placebo (glycine) were administered from admission until day +28 in 193 BMT patients in a randomized, double-blind, placebo-controlled study at a dose of 1.0 g amino acid/m2/dose swish and swallow four times a day. In autologous BMT patients (n = 87) glutamine was associated with significantly less mouth pain by self report and by opiate use (5.0+/-6.2 days of morphine for glutamine vs 10.3+/-9.8 days for placebo; P= 0.005). Matched sibling BMT patients had no effect by self report and an increased duration of opiate use (23.2+/-5.7 days for glutamine vs 16.3+/-8.3 days for placebo) (P = 0.002). However, day 28 survival of allogeneic patients was improved by glutamine. No significant differences in TPN use, rate of relapse or progression of malignancy, parenteral antibiotic use, acute or chronic GVHD, or days of hospitalization were observed in either autologous or allogeneic recipients. No toxicity of glutamine was observed. We conclude that oral glutamine can decrease the severity and duration of oropharyngeal mucositis in autologous BMT patients but not in allogeneic BMT patients, possibly due to interaction with methotrexate. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/9722068/Effect_of_low_dose_oral_glutamine_on_painful_stomatitis_during_bone_marrow_transplantation_ L2 - http://dx.doi.org/10.1038/sj.bmt.1701317 DB - PRIME DP - Unbound Medicine ER -