title: Application of Glutamine-enriched nutrition therapy in childhood acute lymphoblastic leukemia.
abstract: We investigated the effects of glutamine (Gln)-enriched nutritional therapy during chemotherapy on the nutritional status and immune function of children with acute lymphoblastic leukemia (ALL).
  
  
  
  We enrolled 48 children who were newly diagnosed with ALL in our department during the period of 2013.1-2014.12. The patients (follow random number table) were randomly divided into the control group (peptamen) and the treatment group (peptamen + glutamine), 24 cases in each group. The remission induction regimens were all based on VDLP (D) chemotherapy (VCR (Vincrisstine), DNR (Daunomycin), L-ASP (L-Asparagiase), Prednisolone and Dexamethasone). The treatment group received Gln-enriched nutritional therapy every day during the full course of chemotherapy,and the control group is as same as the treatment group except without glutamine. The indicators of general nutritional status, such as weight, height, and triceps skinfold thickness, and the indicators of biochemical tests, such as serum albumin, prealbumin, creatinine-height index, retinol binding protein, and urinary hydroxyproline index, were compared between the two groups at the end of the first, second, third and the fourth week when the chemotherapy was completed. And in the fourth week, flow cytometry was applied to detect the levels of T cell subsets and the activities of natural killer (NK) cells in peripheral blood of the two groups.
  
  
  
  1. after 4 weeks nutritional therapy, there is no significant difference (p > 0.05) between the two groups of children in weight, height and other indicators. 2. At the end of 2 weeks treatment, the level of prealbumin (PA) and retinol-binding protein (RBP) is higher in treatment group than that in the control group (P <0.05), at the end of 3 weeks treatment, the thickness of triceps skinfold is higher (P <0.05) than that in the control group; 3. At the end of 3 and 4 weeks, the concentrations serum ALB, PA, RBP and UHI were higher than in the control group (P <0.05); 4. There is statistically significant (p < 0.05) between the two groups in edema incidence; 5. At the end of treatment (4 weeks), the percentages of CD3 +, CD4 +, CD4 +/CD8 +, NK cell are significantly decreased in the two groups (P <0.05).
  
  
  
  Gln-enriched nutritional therapy can effectively improve the systemic nutritional status of children with leukemia, improve immune function.
authors.affiliation: Department of Pediatrics, Liaocheng People's Hospital, Liaocheng, Shandong Province, Zip 252000, People's Republic of China. hanyueqintg@163.com.|Department of Pediatric Hematology, Liaocheng People's Hospital, Research direction: childhood leukemia and cancer, Liaocheng, People's Republic of China. hanyueqintg@163.com.
authors.forename: Yueqin
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Nutrition, Liaocheng People's Hospital, Liaocheng, Shandong Province, Zip 252000, People's Republic of China.|Department of Nutrition, Liaocheng People's Hospital, Research direction: nutrition interventions in patients with cancer and wasting syndrome, Liaocheng, People's Republic of China.
authors.forename: Fengzhi
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Department of Pediatrics, Liaocheng People's Hospital, Liaocheng, Shandong Province, Zip 252000, People's Republic of China.
authors.forename: Jinshen
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Pediatrics, Liaocheng People's Hospital, Liaocheng, Shandong Province, Zip 252000, People's Republic of China.
authors.forename: Yanping
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Pediatrics, Liaocheng People's Hospital, Liaocheng, Shandong Province, Zip 252000, People's Republic of China.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Dai
authors.affiliation: Department of Pediatrics, Liaocheng People's Hospital, Liaocheng, Shandong Province, Zip 252000, People's Republic of China.
authors.forename: Yueqing
authors.initials: Y
authors.lastname: Bu
authors.affiliation: Department of Pediatrics, Liaocheng People's Hospital, Liaocheng, Shandong Province, Zip 252000, People's Republic of China.
authors.forename: Qiaozhi
authors.initials: Q
authors.lastname: Yang
authors.affiliation: Department of Pediatrics, Liaocheng People's Hospital, Liaocheng, Shandong Province, Zip 252000, People's Republic of China.
authors.forename: Yingying
authors.initials: Y
authors.lastname: Xiao
authors.affiliation: Department of Pediatrics, Liaocheng People's Hospital, Liaocheng, Shandong Province, Zip 252000, People's Republic of China.
authors.forename: Xiaojing
authors.initials: X
authors.lastname: Sun
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D005260:Female; D005973:Glutamine / Q000008:administration & dosage*; D006801:Humans; D006909:Hydroxyproline / Q000097:blood; D007223:Infant; D007694:Killer Cells, Natural / Q000187:drug effects; D008297:Male; D009752:Nutritional Status; D018529:Nutritional Support; D011228:Prealbumin / Q000378:metabolism; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D012177:Retinol-Binding Proteins / Q000378:metabolism; D012709:Serum Albumin / Q000378:metabolism
chemical_list: D011228:Prealbumin; D012177:Retinol-Binding Proteins; D012709:Serum Albumin; D005973:Glutamine; D003404:Creatinine; D006909:Hydroxyproline
keywords: Childhood acute lymphoblastic leukemia (ALL); Creatinine-height index (CHI); Glutamine (Gln); Immune function; Nutrition therapy; Prealbumin (PA); Retinol binding protein (RBP); Serum albumin (ALB); Urinary hydroxyproline index (UHI)