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Parenteral Nutrition

Standardized parenteral alanyl-glutamine dipeptide supplementation is not beneficial in autologous transplant patients: a randomized, double-blind, placebo controlled study

Bone Marrow Transplantation volume 30, pages 953–961 (2002)Cite this article

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 vs4.3 ± 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.

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Acknowledgements

Thanks to Ms Jana Kovarikova and Ms Jana Potockova for administrative help. Special thanks to Dr Peter RE Johnson for critical review of the manuscript. This study was supported by the grant IGA 5502/3 of Czech Ministry of Public Health.

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Authors and Affiliations

  1. Department of Clinical Haematology, University Hospital Královské Vinohrady, Prague, Czech Republic

    R Pytlík, M Patorková, E Gregora & T Kozák

  2. 1st Department of Medicine, General University Hospital, Prague, Czech Republic

    R Pytlík

  3. Department of Medicine, Hospital Na Homolce, Prague, Czech Republic

    P Beneš

  4. Department of Clinical Nutrition, University Hospital KrálovskéVinohrady, Prague, Czech Republic

    E Chocenská

  5. Department of Informaticals and Biostatistics, Public Health Institute, Prague, Czech Republic

    B Procházka

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Pytlík, R., Beneš, 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 30, 953–961 (2002). https://doi.org/10.1038/sj.bmt.1703759

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  • DOI: https://doi.org/10.1038/sj.bmt.1703759

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