972
document
Oral and parenteral glutamine in bone marrow transplantation : a randomized , double-blind study . BACKGROUND Total parenteral nutrition ( TPN ) supplemented with glutamine ( GLN ) has been reported to be effective for patients with bone marrow transplantation ( BMT ) . Our aim was to evaluate enteral and parenteral glutamine in patients undergoing BMT . METHODS For evaluation of GLN in BMT , 66 patients with 43 hematologic and 23 solid malignancies ( 21 breast carcinomas ) , were randomized , double-blinded , to either oral GLN ( n = 35 ) or glycine-control ( GLY ) ( n = 31 ) , 10 g three times daily . When TPN became necessary , patients who received GLN orally were given TPN with GLN ( 0.57 g/kg ) . Those who received GLY received standard TPN , isocaloric and isonitrogenous . Patients with hematologic malignancies received high-dose chemotherapy , total body irradiation , and either allogeneic ( ALLO ) BMT ( n = 18 ) or autologous ( AUTO ) stem cell transplantation ( n = 25 ) . Patients with solid malignancies ( n = 23 ) received AUTO . RESULTS There were 14 in-hospital deaths without relationship to GLN administration . For respective comparisons of ALLO and AUTO transplants in the GLN and GLY hematologic groups and AUTO in the solid tumor groups , there were no significant differences in hospital stay , duration of stay after BMT , TPN days , neutrophil recovery > 500/mm3 , incidence of positive blood cultures , sepsis , mucositis , and diarrhea . Acute graft us host disease occurred in 1 of 10 hematologic patients receiving GLN and in 3 of 8 patients receiving GLY placebo ( p > .05 ) . Possible reduction in need for TPN and a suggestion of improved long-term survival were associated with GLN . CONCLUSIONS Oral and parenteral GLN seemed to be of limited benefit for patients having AUTO or ALLO BMT for hematologic or solid malignancies . Further study of long-term effects of GLN in BMT seems warranted .
973
Intervention_Pharmacological
glutamine
974
Intervention_Pharmacological
Total parenteral nutrition ( TPN ) supplemented with glutamine ( GLN )
975
Intervention_Pharmacological
oral GLN
976
Intervention_Control
glycine-control
977
Intervention_Pharmacological
TPN
978
Intervention_Pharmacological
GLN
979
Intervention_Pharmacological
TPN
980
Intervention_Pharmacological
GLN
981
Intervention_Pharmacological
TPN
982
Intervention_Pharmacological
high-dose chemotherapy , total body irradiation , and either allogeneic ( ALLO ) BMT
983
Intervention_Surgical
stem cell transplantation
984
Intervention_Pharmacological
AUTO
985
Intervention_Pharmacological
GLN
986
Outcome_Other
hospital stay , duration of stay after BMT , TPN days
987
Outcome_Physical
neutrophil recovery > 500/mm3 , incidence of positive blood cultures
988
Outcome_Adverse-effects
sepsis , mucositis , and diarrhea
989
Outcome_Adverse-effects
Acute graft us host disease
990
Outcome_Mortality
improved long-term survival
991
Participant_Condition
patients with bone marrow transplantation ( BMT )
992
Participant_Condition
patients undergoing BMT
993
Participant_Sample-size
66 patients
994
Participant_Sample-size
43
995
Participant_Sample-size
23
996
Participant_Sample-size
21
997
Participant_Condition
Patients with hematologic malignancies
998
Participant_Sample-size
14
999
Participant_Condition
relationship to GLN administration .
1000
Participant_Sample-size
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