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Post-Transplant Events

A double-blind randomized placebo-controlled study of oral glutamine in the prevention of mucositis in children undergoing hematopoietic stem cell transplantation: a pediatric blood and marrow transplant consortium study

Bone Marrow Transplantation volume 36, pages 611–616 (2005)Cite this article

Summary:

Severe mucositis is a common cause of morbidity in hematopoietic stem cell transplant (HSCT) recipients. Glutamine has been shown to reduce mucositis in children receiving chemotherapy. Patients were randomized in a double-blind manner to receive glutamine or glycine at a dose of 2 g/m2/dose (maximum dose 4 g) twice daily until 28 days post transplant or discharge if sooner. Mucositis was graded by use of a modified Walsh scale. A total of 120 children were evaluable: 57 children received glutamine and 63 received glycine. The mean mucositis score was 3.0±0.3 vs 3.9±0.4 (P=0.07) in the glutamine and glycine groups, respectively. The glutamine group demonstrated a reduction in mean number of days of intravenous narcotics use (12.1±1.5 vs 19.3±2.8 in the glycine group, P=0.03) and total parenteral nutrition (17.3±1.7 vs 27.3±3.6 in glycine group, P=0.01). There was no statistically significant difference in toxicity between the two groups. Glutamine appears to be safe and beneficial in reducing the severity of mucositis. Strong consideration should be given to include oral glutamine supplementation as a routine part of supportive care of SCT patients.

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Acknowledgements

Participating Centers of the Pediatric Blood and Marrow Transplant Consortium are as follows: UT Southwestern Medical Center at Dallas; Nemours Children's Clinic – Jacksonville; Children's Hospital Medical Center of Akron; Children's National Medical Center; Columbia University Medical Center/Children's Hospital of New York; Long Island Jewish Health System; University of South Carolina; Roswell Park Cancer Institute; Texas Transplant Institute; University of Calgary; Rainbow Babies & Children's Hospital; Washington University Medical Center. This work was supported by The Children's Cancer Fund, Wipe Out Kids Cancer, and the Nemours Foundation.

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Authors and Affiliations

  1. Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA

    V M Aquino

  2. Children's Medical Center Dallas, Dallas, TX, USA

    V M Aquino & G B Jackson

  3. Nemours Children's Clinic, Jacksonville, FL, USA

    A R Harvey & E S Sandler

  4. Columbia University Medical Center, New York, NY, USA

    J H Garvin

  5. Doernbecher Children's Hospital, Portland, OR, USA

    K T Godder

  6. Rainbow Babies and Children's Hospital, Cleveland, OH, USA

    M L Nieder

  7. Phoenix Children's Hospital, Phoenix, AZ, USA

    R H Adams

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Aquino, V., Harvey, A., Garvin, J. et al. A double-blind randomized placebo-controlled study of oral glutamine in the prevention of mucositis in children undergoing hematopoietic stem cell transplantation: a pediatric blood and marrow transplant consortium study. Bone Marrow Transplant 36, 611–616 (2005). https://doi.org/10.1038/sj.bmt.1705084

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