Omega-3 Poly-Unsaturated Fatty Acids for the Prevention of Severe Neutropenic Enterocolitis in Patients with Acute Myeloid Leukemia

Abstract

Neutropenic enterocolitis is a potentially fatal complication of myeloablative chemotherapy in patients with acute myeloid leukemia. Omega-3 polyunsaturated fatty acids (PUFA) are precursors of potent anti-inflammatory prostaglandins. Our aim was to explore the safety and effectiveness of omega-3 PUFA added to parenteral nutrition in protecting leukemia patients from severe enterocolitis. Fourteen patients with acute myeloid leukemia who received omega-3 PUFA in a Phase II trial were compared with 66 consecutive control patients not getting this intervention. We performed crude and adjusted comparisons, using inverse probability of treatment weighting for adjusted analysis, and blind outcome assessment to minimize assessor bias. Primary outcome was severe enterocolitis (≥Grade 3). The crude odds ratio of Grade 3 colitis or higher was 1.36 (95% CI 0.37 to 4.96, P = 0.64), and the adjusted odds ratio was 0.79 (95% CI 0.35 to 1.78, P = 0.57). There was little evidence to suggest differences between groups in serious adverse events and overall mortality. Our results provide little evidence that addition of omega-3 PUFA is beneficial in this condition. Routine treatment with omega-3 PUFA is currently not warranted.

Telomerase Inhibition in the Treatment of Leukemia: A Comprehensive Review

“…Ω-3 fatty acids effectively target the nuclear factor kappa B (NFκB) pathway in chronic lymphocytic leukemia (CLL), which plays a vital role in the control of apoptosis and progression of hematologic malignancies [82]. It was also used to prevent severe neutropenic enterocolitis in patients with AML, and cardiotoxicity in children with ALL, who are treated with doxorubicin [83,84]. Moreover, it was proven to reduce inflammatory risk in patients undergoing chemotherapy, due to hematological malignancies [85].…”

ω-3 Polyunsaturated Fatty Acids on Colonic Inflammation and Colon Cancer: Roles of Lipid-Metabolizing Enzymes Involved

“…In randomized, placebo-controlled trials, ω-3 PUFAs intake has had no effect in improving the recovery of colitis [63,64], and has even enhanced disease activity in UC patients [65]. Moreover, ω-3 PUFAs had no effect on either chemotherapy-induced enterocolitis in acute myeloid leukemia (AML) patients [66] or type 2 diabetes-induced duodenal inflammation in obesity patient [67]. In animal models, the treatment of fish oil has had little effect on DSS-or TNBS-induced colitis in rats [68,69], and has exacerbated the DSS-induced colitis in mice [70].…”

Leczenie żywieniowe u chorych na nowotwory układów krwiotwórczego i chłonnego

“…Celem dodawania kwasów tłuszczowych omega 3 jest ograniczenie tworzenia prozapalnych tromboksanów, prostaglandyn i leukotrienów. Stwierdzono również, że powodują one redukcję stanu zapalnego w różnych schorzeniach przewodu pokarmowego, a w przypadku chorych na ostre białaczki szpikowe sprzyjają ograniczeniu występowania i nasilenia neutropenicznego zapalenia jelit [23].…”