Avaliação do papel da glutamina nos desfechos relacionados ao transplante alogênico de célulastronco hematopoiéticas

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

Fifty-three patients with hematological malignancies who underwent allogeneic stem cell transplantation (SCT) from HLA-identical siblings were randomly assigned to receive glutamine enriched parenteral nutrition - PN (GlPN, n = 27) or standard PN (PN, n = 26), in isonitrogenous solutions. Deaths (D+100 and D+180), infections, acute GVHD, length of stay (LOS), time of neutropenia and intestinal permeability (IP) were studied. Ages, gender, diagnosis, disease status and treatment variables were equally distributed between groups. Survival on D+180 was increased in GlPN (74%) vs. PN (46 %), p= 0.03 (log-rank), reaching the limit of statistical significance on D+100 (p = 0.05). Most deaths occurred before D+100, especially in PN (10/26, 39 %) versus 15 % (4/27) in GlPN. GVHD was the most frequent cause of death (8/21, 38%), especially in PN (n = 6, 5 before D+100). Other outcomes were not affected. IP was affected on admission, was not affected by glutamine enrichment, but consistently worsened throughout the study. Results showed that glutamine enriched PN was efficacious in increasing short-term survival after allo-SCT. Benefits of glutamine seem to be independent of mucosal protection, as IP was not affected by its use. A trend to a lower incidence of GVHD deaths may suggest an immunomodulatory role of glutamine.

ASSUNTO(S)

nutrição parenteral decs dissertações acadêmicas decs glutamina decs dissertação da faculdade de medicina. ufmg doença enxerto-hospedeiroo decs transplante homólogo decs transplante de células-tronco hematopoiéticas/utilização decs

ACESSO AO ARTIGO

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