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document
Plasma antioxidant status after high-dose chemotherapy : a randomized trial of parenteral nutrition in bone marrow transplantation patients . BACKGROUND Chemotherapy and radiation therapy result in increased free radical formation and depletion of tissue antioxidants . It is not known whether parenteral nutrition ( PN ) administered during bone marrow transplantation ( BMT ) supports systemic antioxidant status . OBJECTIVE The aims of the study were to determine 1 ) whether high-dose chemotherapy decreases concentrations of major circulating antioxidants in patients undergoing BMT and 2 ) whether administration of standard PN maintains systemic antioxidant concentrations compared with PN containing micronutrients and minimal lipids alone . DESIGN Twenty-four BMT patients were randomly assigned to receive either standard PN containing conventional amounts of dextrose , amino acids , micronutrients , and lipid ( 120 kJ/d ) or a solution containing only micronutrients ( identical to those in standard PN ) and a small amount of lipid ( 12 kJ/d ) . Plasma antioxidant status was measured before conditioning therapy and serially at days 1 , 3 , 7 , 10 , and 14 after BMT . RESULTS Plasma glutathione ( GSH ) and alpha- and gamma-tocopherol concentrations decreased and the GSH redox state became more oxidized after conditioning chemotherapy . Plasma cysteine concentrations were unchanged , whereas cystine concentrations increased . Plasma vitamin C and zinc concentrations and GSH peroxidase activity increased over time . Plasma alpha-tocopherol concentrations were lower in patients given standard PN . There were no differences in other plasma antioxidants between groups . CONCLUSIONS A significant decline in GSH-glutathione disulfide , cysteine-cystine , and vitamin E status occurs after chemotherapy and BMT . Standard PN does not improve antioxidant status compared with administration of micronutrients alone . Further evaluation of PN formulations to support patients undergoing high-dose chemotherapy and BMT are needed .
3824
Intervention_Pharmacological
high-dose chemotherapy
3825
Intervention_Pharmacological
Chemotherapy and radiation therapy
3826
Intervention_Pharmacological
parenteral nutrition ( PN )
3827
Intervention_Surgical
bone marrow transplantation ( BMT )
3828
Intervention_Pharmacological
high-dose chemotherapy
3829
Intervention_Surgical
BMT
3830
Intervention_Pharmacological
PN
3831
Intervention_Pharmacological
PN
3832
Intervention_Surgical
BMT
3833
Intervention_Pharmacological
standard PN containing conventional amounts of dextrose , amino acids ,
3834
Intervention_Physical
micronutrients
3835
Intervention_Pharmacological
, and lipid
3836
Intervention_Physical
solution containing only micronutrients
3837
Intervention_Pharmacological
chemotherapy
3838
Intervention_Surgical
BMT
3839
Intervention_Pharmacological
high-dose chemotherapy
3840
Intervention_Surgical
BMT
3841
Outcome_Physical
Plasma antioxidant status
3842
Outcome_Physical
Plasma glutathione ( GSH )
3843
Outcome_Physical
alpha- and gamma-tocopherol concentrations
3844
Outcome_Physical
GSH redox state
3845
Outcome_Physical
Plasma cysteine concentrations
3846
Outcome_Physical
Plasma vitamin C and zinc concentrations
3847
Outcome_Physical
GSH peroxidase activity
3848
Outcome_Physical
Plasma alpha-tocopherol concentrations
3849
Outcome_Physical
plasma antioxidants
3850
Outcome_Physical
GSH-glutathione disulfide
3851
Outcome_Physical
cysteine-cystine
3852
Outcome_Physical
vitamin E status
3853
Participant_Condition
bone marrow transplantation
3854
Participant_Sample-size
Twenty-four
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Participant_Condition
patients undergoing high-dose chemotherapy