title: 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.
authors.affiliation: Department of Internal Medicine, Bern University Hospital, Bern, Switzerland. johannes.buekki@med.uni-muenchen.de
authors.forename: Johannes
authors.initials: J
authors.lastname: Bükki
authors.forename: Zeno
authors.initials: Z
authors.lastname: Stanga
authors.forename: Firouzeh Buitrago
authors.initials: FB
authors.lastname: Tellez
authors.forename: Kathleen
authors.initials: K
authors.lastname: Duclos
authors.forename: Mirjam
authors.initials: M
authors.lastname: Kolev
authors.forename: Peter
authors.initials: P
authors.lastname: Krähenmann
authors.forename: Thomas
authors.initials: T
authors.lastname: Pabst
authors.forename: Samuel
authors.initials: S
authors.lastname: Iff
authors.forename: Peter
authors.initials: P
authors.lastname: Jüni
mesh_terms: D000328:Adult; D000368:Aged; D044504:Enterocolitis, Neutropenic / Q000517:prevention & control*; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition; D010865:Pilot Projects; D016896:Treatment Outcome
chemical_list: D015525:Fatty Acids, Omega-3