Glutamine supplementation in cancer patients receiving bone marrow transplantation and high dose chemotherapy

Glutamine supplementation of enteral and parenteral nutrition support has r eceived increased attention in the research community over the past decade. Glutamine may become a conditionally essential nutrient during certain cat abolic states, including after bone marrow transplantation (BMT). The admin istration of enteral or parenteral glutamine seems safe and also potentiall y efficacious in some patient groups undergoing intensive treatment for can cer. Studies indicate that adjunctive glutamine treatment may improve nitro gen retention, decrease clinical infection and length of hospital stay and reduce the incidence and severity of mucositis after BMT and high dose chem otherapy. Although not all studies demonstrate benefit, there are sufficien t positive data to suggest that this nutrient should be considered in the m etabolic support of many individuals undergoing the catabolic process of ma rrow transplantation. Given the available data, randomized, double-blind, c ontrolled clinical trials of glutamine-enriched nutrition in patients recei ving BMT and high dose chemotherapy protocols are indicated to further defi ne the utility of this amino acid as adjunctive therapy. Studies of glutami ne nutrition combined with current combinations of cytoreductive agents and hematopoietic growth factors in BMT will be particularly pertinent.