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Systematic review and meta-analyses of studies of glutamine supplementation in haematopoietic stem cell transplantation.

Abstract：

:It is unclear whether supplemental glutamine is of benefit in haematopoietic stem cell transplantation (HSCT). We performed a systematic review and meta-analyses using Cochrane methodology. Seventeen randomized controlled trials (RCTs) were found. There was considerable heterogeneity between studies in terms of patient demographics and glutamine administration schedule. Many of the studies were small and scored poorly on methodological quality. Oral glutamine may reduce mucositis (average mucositis score: standard mean difference -0.38, 95% confidence interval (CI) -0.59 to -0.16) and days of opioids (mean difference -1.95 days, 95% CI -3.66 to -0.25) and GVHD (relative risk 0.42, 95% CI 0.21-0.85). Glutamine (i.v.) may reduce clinical infections (relative risk 0.75, 95% CI 0.58 to 0.97) and positive cultures (relative risk 0.72, 95% CI 0.57-0.91) but may also increase the risk of relapse (relative risk 2.91, 95% CI 1.34-6.29) but this is based on only two small studies. There was no effect of oral or i.v. glutamine on overall transplant-related mortality at day +100. In conclusion, there may be beneficial effects of glutamine in HSCT but larger, well-designed studies are required to confirm the beneficial effects and investigate possible adverse effects.

journal_name

Bone Marrow Transplant

journal_title

Bone marrow transplantation

authors

Crowther M,Avenell A,Culligan DJ

doi

10.1038/bmt.2009.41

subject

Has Abstract

pub_date

2009-10-01 00:00:00

pages

413-25

issue

7

eissn

0268-3369

issn

1476-5365

pii

bmt200941

journal_volume

44

pub_type

杂志文章,meta分析,评审

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