Eficacia de la glutamina parenteral en pacientes sometidos a trasplante autólogo de médula ósea
2012
Introduction: Autologous bone marrow transplant
(ABMT) represents a high metabolic stress. Glutamine
has proven to be effective in severe catabolic states,
although there are controversial studies.
Objectives: To assess the effect of parenteral nutrition
(PN) therapy supplemented with glutamine on the occurrence
of mucositis and mean hospital stay in patients submitted
to ABMT.
Methods: Retrospective study of patients submitted to
ABMT between 2006 and 2009. In 2008, one vial of Lalanyl-
L-glutamine (20 g) was added by protocol to the
PN formulations of these patients. Thirteen clinical
charts since that date (glutamine group) and 13 previous
charts (control group) were randomly selected (n = 26).
We compared the degree of mucositis and hospital stay in
both groups. In the subgroup of glutamine-treated
patients, we compare the glutamine dose in the patients
developing some degree of mucositis with that of those not
having this complication.
Results: Mean hospital stay: 27.8 ± 7.4 days (control
group) vs. 20.3 ± 5.3 days (glutamine group) (p = 0.01).
The severity of mucositis was lower in the glutaminetreated
group (p = 0.02). The weight-adjusted dose of Lalanyl-
L-glutamine in the patients not developing
mucositis was higher than in the other ones (0.32 vs. 0.24
g/kg/day; p = 0.02).
Conclusions: Glutamine supplementation reduces the
degree of mucositis and hospital stay in patients submitted
to autologous bone marrow transplantation. The
degree of mucositis is lower in the subgroup of patients
receiving higher doses of glutamine.
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