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Effect of low-dose oral glutamine on painful stomatitis during bone marrow transplantation.
Bone Marrow Transplant 1998; 22(4):339-44BM

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.

Authors+Show Affiliations

Department of Pediatrics, University of Minnesota Medical School, Minneapolis, USA.No affiliation info availableNo 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

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 -