The effect of high-dose enteral glutamine on the incidence and severity of mucositis in paediatric oncology patients.
OBJECTIVE
The study was conducted to determine if enteral glutamine, 0.65 g kg(-1) daily for 7 days, is effective in reducing the incidence and severity of mucositis in paediatric oncology patients when given alongside chemotherapy. The study was carried out at St James's University Hospital, Leeds, UK.


METHODS
This was a randomized study using the patients as their own controls. Seventy-six patients undergoing treatment for paediatric malignancy having at least two identical courses of chemotherapy and at risk of developing mucositis participated in the study. Patients received one course of chemotherapy with glutamine and an identical course without. Alternate patients were allocated to have glutamine with course 1 or with course 2. The severity of symptoms of mucositis and the duration of enteral and parenteral nutrition were recorded. Daily ammonia levels were measured.


RESULTS
Fifty patients completed the study. No statistical significance with regard to symptoms of mucositis was found. Fewer children receiving glutamine required parenteral nutrition (P=0.049), and the duration of parenteral nutrition was less (P=0.023). No adverse effects attributed to taking the glutamine were observed.


CONCLUSIONS
The study showed that high-dose enteral glutamine did not reduce the incidence and severity of oral mucositis as determined by subjective toxicity measurements, but did show a significant reduction in parenteral nutrition usage. No adverse cumulative effect of this oral glutamine dose was observed.
Ward
E
E
Dietetic Department, St James's University Hospital, Leeds, UK. Evelyn.Ward@leedsth.nhs.uk
Smith
M
M
Henderson
M
M
Reid
U
U
Lewis
I
I
Kinsey
S
S
Allgar
V
V
Bowers
D
D
Picton
S V
SV
D000284:Administration, Oral; D000293:Adolescent; D000641:Ammonia / Q000032:analysis / Q000097:blood; D000970:Antineoplastic Agents / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004750:Enteral Nutrition; D005260:Female; D041981:Gastrointestinal Tract / Q000187:drug effects*; D005973:Glutamine / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D052016:Mucositis / Q000139:chemically induced / Q000188:drug therapy* / Q000503:physiopathology; D009369:Neoplasms / Q000188:drug therapy; D010288:Parenteral Nutrition; D055815:Young Adult
D000970:Antineoplastic Agents; D005973:Glutamine; D000641:Ammonia