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Post-Transplant Events

Efficacy of glutamine-supplemented parenteral nutrition on short-term survival following allo-SCT: a randomized study

Bone Marrow Transplantation volume 41, pages 1021–1027 (2008)Cite this article

Abstract

Fifty-three patients with hematological malignancies who underwent Allo-SCT from HLA-identical siblings were randomly assigned to receive glutamine-enriched parenteral nutrition—PN (GlPN, n=27) or standard PN (PN, n=26), in isonitrogenous solutions. Deaths (D+100 and D+180), infections, acute GVHD, length of stay, time of neutropenia and intestinal permeability (IP) were studied. Ages, gender, diagnosis, disease status and treatment variables were equally distributed between groups. Survival on D+180 was increased in GlPN (74%) vs PN (46%), P=0.03 (log-rank), as on D+100 (P=0.05). Most deaths occurred before D+100, especially in PN (10/26, 39%) vs GlPN (4/27, 15%). GVHD was the most frequent cause of death (8/21, 38%), especially in PN (n=6, five before D+100). Other outcomes were not affected. IP was affected on admission, was not affected by glutamine enrichment, but consistently worsened throughout the study. Results showed that GlPN was efficacious in increasing short-term survival after Allo-SCT. Benefits of glutamine seem to be independent of mucosal protection, as IP was not affected by its use. A trend to a lower incidence of GVHD deaths may suggest an immunomodulatory role of glutamine.

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Acknowledgements

HOGT designed the study, took part in the collection of clinical and outcome information and in the performance of intestinal permeability tests; EGV and ASC were responsible for intestinal permeability tests; EMAG took part in the study design and statistical/epidemiological analysis; MHCS and ACCA took part in data collection and performance of intestinal permeability tests; WMA and FML took part in study design and in the collection of clinical and outcome information; AAS was responsible for randomization and technical aspects concerning PN and glutamine supplementation; HNSB took part in the collection of clinical and outcome information and statistical/epidemiological analysis.

Funding: Glutamine was supplied without charge by Fresenius Kabi, Campinas, Brazil.

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Authors and Affiliations

  1. Nutritional Support Committee, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, Brazil

    H O da Gama Torres

  2. School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil

    H O da Gama Torres, A S da Cunha, E M A Goulart, M H C Souza, A C C Aguirre, W M Azevedo & H N S Bittencourt

  3. Department of Gastroenterology, Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, Brazil

    E G Vilela & A S da Cunha

  4. Department of Hematology/Bone Marrow Transplantation, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, Brazil

    F M Lodi & H N S Bittencourt

  5. Pharmacy, Hospital das Cínicas, Federal University of Minas Gerais, Belo Horizonte, Brazil

    A A Silva

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  1. H O da Gama Torres
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da Gama Torres, H., Vilela, E., da Cunha, A. et al. Efficacy of glutamine-supplemented parenteral nutrition on short-term survival following allo-SCT: a randomized study. Bone Marrow Transplant 41, 1021–1027 (2008). https://doi.org/10.1038/bmt.2008.27

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