Pilot Study: Effects of Parenteral Glutamine Dipeptide Supplementation on Neutrophil Functions and Prevention of Chemotherapy-Induced Side-Effects in Acute Myeloid Leukaemia Patients

Abstract

1383The effect of parenteral glutamine dipeptide (Gln) supplementation on neutrophil phagocytosis, superoxide anion generation (SAG), prevention of chemotherapy-induced side-effects and cost-effectiveness was examined in a pilot study of acute myeloid leukaemia (AML) patients receiving chemotherapy. Sixteen AML patients were randomized to receive intravenous supplementation with Gln (30 g/day) or an equivalent quantity (25 g/day) of a standard amino acid mixture (control) on days 1 -5 of chemotherapy. Complete blood count was evaluated twice a week until hospital discharge, and neutrophil phagocytosis and SAG were measured when absolute neutrophil count reached > 500 /µl. Patients were observed for development of infection, mucositis and diarrhoea. In Gln-treated patients, the percentage of neutrophil phagocytosis and the SAG levels were significantly higher than in control patients (20.5 ± 6.0% and 18.9 ± 2.9 nmol/10 6 neutrophils per 10 min, respectively). The Gln-treated patients lost significantly less weight, tended to have shorter in-patient duration and had less severe oral mucositis than controls. This pilot study provides preliminary indication that parenteral Gln supplementation enhances neutrophil phagocytic function, maintains nutritional status and is cost effective. Parenteral Gln may also prevent oral mucositis, although further studies involving more patients need to be undertaken to confirm this and the other results.

Gastrointestinal complications in children with acute myeloid leukemia

“…Several chemotherapeutic agents have been associated with enterocolitis, including daunorubicin [48,55,56], cytarabine [46][47][48][55][56][57], etoposide [46,47,56,57], doxorubicin [46,47,55], cyclophosphamide [46,55], vincristine [46,55], and methotrexate [46] (Table I). Enteritis specifically has been associated with cytarabine, 6-mercaptopurine, thioguanine, and daunorubicin [48,50].…”

MJ-29 Inhibits Tubulin Polymerization, Induces Mitotic Arrest, and Triggers Apoptosis via Cyclin-Dependent Kinase 1-Mediated Bcl-2 Phosphorylation in Human Leukemia U937 Cells

“…Microtubule-targeting agents (MTAs) are primarily used, and they are the most effective drugs in leukemia treatment (Perez, 2009). However, clinically used MTAs remain highly toxic to normal tissues (Tallman, 1996;Sornsuvit et al, 2008;Itzykson et al, 2009;Sitaresmi et al, 2009). Therefore, discovering a new antileukemia agent that is more effective and less toxic for leukemia patients is necessary.…”

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“…Das Interesse an Glutamin beruht auf dem hohen Glutaminumsatz der gastrointestinalen Mukosa [242] sowie tierexperimentellen Beobachtungen, dass Glutamin gegenüber unterschiedlichen Noxen protektive Effekte vermittelt [300]. Zur Beeinflussung der Mukositis kommen prinzipiell oral oder parenteral verabreichtes Glutamin in Betracht; mit beiden Ansätzen wurden günstige Wirkungen auf Entzündungserscheinungen [302] und Symptome wie Erbrechen und Durchfall [336,337] sowie vereinzelt auch auf hämatologi-sche Befunde berichtet [338]. Eine Übersicht zum Einsatz von Gutamin zur Linderung einer oralen Mukositis unter normal dosierter Chemotherapie berichtete über mehrere sehr kleine Studien, die einen Vorteil dokumentierten, während größere Untersuchungen ohne Wirknachweis blieben [300].…”