Intravenous glutamine does not modify leucocyte count but shortens duration of mucositis after bone marrow transplant

Abstract

Rationale: Intravenous administration of Glutamine dipeptides (Gln) has been proposed as treatment of oral mucositis following a bone marrow transplant (BMT). Objective: To establish the effects of intravenous Gln supplementation upon the severity of oral mucositis after BMT. Study design: Retrospective, analytical. Study serie: Records from 25 patients (Males: 56.0%; BMT cause: Leukemia: 64.0%) who developed oral mucositis (Grades III – IV: 48.0%) after BMT (Autologous: 44.0%) at the "Juan Tanca Marengo" Hospital (Guayaquil, Ecuador) between 2009 – 2017. Glutamine source: Dipeptiven©®: 13 grams of Gln suspended in 100 milliliters of a 20% solution of the alanine-glutamine dipeptide (Fresenius-Kabi©®, Germany). Materials and Methods: Gln-treated patients received 3(4.0% of the treatment leg), 5 (20.0%); 6 (12.0%); 7 (48.0%); or 10 (16.0%) doses of the dipeptide until resolution of the symptoms. Impact of Gln was estimated from changes observed in the severity and duration of mucositis, white blood cell counts, and body weight regarding 25 non-Gln treated patients (Males: 68.0%; Leukemias: 32.0%; Autologous graft: 68.0%; Grade III – IV mucositis: 48.0%). Results: Intravenously-administered Gln shortened duration of oral mucositis: Gln-Treated: 12.5 ± 5.1 days vs. Non-Gln Treated: 21.3 ± 17.8 days (p < 0.05). Also, intravenous Gln marginally ameliorated loss of body weight: Gln-Treated -4.5 ± 5.5% vs. Non-Gln Treated: -7.5 ± 5.7% (p = 0.07). Conclusions: Intravenous Gln administration shortens duration of oral mucositis following BMT. Gln effect might be translated to a lesser weight loss in patients with oral mucositis.

Keywords

• mucositis
• glutamine
• bone marrow transplant
• ; chemotherapy
• radiotherapy