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Post-Transplant Events

Systematic review and meta-analyses of studies of glutamine supplementation in haematopoietic stem cell transplantation

Bone Marrow Transplantation volume 44, pages 413–425 (2009)Cite this article

Abstract

It is unclear whether supplemental glutamine is of benefit in haematopoietic stem cell transplantation (HSCT). We performed a systematic review and meta-analyses using Cochrane methodology. Seventeen randomized controlled trials (RCTs) were found. There was considerable heterogeneity between studies in terms of patient demographics and glutamine administration schedule. Many of the studies were small and scored poorly on methodological quality. Oral glutamine may reduce mucositis (average mucositis score: standard mean difference −0.38, 95% confidence interval (CI) −0.59 to −0.16) and days of opioids (mean difference −1.95 days, 95% CI −3.66 to −0.25) and GVHD (relative risk 0.42, 95% CI 0.21–0.85). Glutamine (i.v.) may reduce clinical infections (relative risk 0.75, 95% CI 0.58 to 0.97) and positive cultures (relative risk 0.72, 95% CI 0.57–0.91) but may also increase the risk of relapse (relative risk 2.91, 95% CI 1.34–6.29) but this is based on only two small studies. There was no effect of oral or i.v. glutamine on overall transplant-related mortality at day +100. In conclusion, there may be beneficial effects of glutamine in HSCT but larger, well-designed studies are required to confirm the beneficial effects and investigate possible adverse effects.

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Acknowledgements

We thank X Jia, R Kucerova and T Lourenco for performing quality assessment and data extraction on the foreign language papers. MC was funded by the Chief Scientist Office of the Scottish Government Health Directorates. AA was funded by a career scientist award from the Chief Scientist Office of the Scottish Government Health Directorates.

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  1. Department of Haematology, Aberdeen Royal Infirmary, Aberdeen, UK

    M Crowther & D J Culligan

  2. Health Services Research Unit, University of Aberdeen, Aberdeen, UK

    M Crowther & A Avenell

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  1. M Crowther
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  2. A Avenell
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  3. D J Culligan
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Correspondence to M Crowther.

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Crowther, M., Avenell, A. & Culligan, D. Systematic review and meta-analyses of studies of glutamine supplementation in haematopoietic stem cell transplantation. Bone Marrow Transplant 44, 413–425 (2009). https://doi.org/10.1038/bmt.2009.41

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