Glutamine: Beneficial to prevent oral mucositis in Mexican children with acute lymphoblastic leukemia?

Abstract

Background: Oral mucositis (OM) is a common side effect of antineoplastic-drug administration. It is frequently related to risk of infection and poor intake of foods and fluids. This might adversely affect the patients’ nutritional status, cause dose reductions, prolong treatment time and length of hospital stay, and increases costs of treatment.

Aim: To investigate if the use of glutamine (Gln) administered by mouthwash during methotrexate(MTX)-chemotherapy in the consolidation-phase reduces oral mucositis in children with acute lymphoblastic leukemia (ALL).

Procedure: A double blind randomized study was conducted from January 2009 to December 2010 with two independent samples. Eligible patients were children with ALL between 0-18 years. These patients were randomized into two groups: an experimental-group and a placebo-group, which received Gln or maltodextrin as placebo.

Results: OM occurred in 10.7% of the experimental group and 13.6% in the control group, with no significant difference in the severity or incidence of OM.

Conclusions: There was no significant difference in the prevention of OM by mouthwash with Gln vs. placebo. Proper oral hygiene and an adequate hyperhydration regimen before and during MTX-chemotherapy, as well as the measurement of serum-methotrexate concentrations are likely to be sufficient to prevent OM.