Impaired intestinal resorption caused by cytostatic treatment - Effect of parenteral glutamine and the preparatory regime
Abstract
Background and objective: Cytostatic therapy often causes severe mucous toxicity with possible nutritional deterioration of patients. Clinical signs of intestinal toxicity and D-xylose absorption were studied in a controlled, randomised, double-blind trial of parenteral glutamine supplementation of autologous peripheral stem cell transplant patients.
Results: A significant impairment of intestinal xylose absorption from day 0 (p = 0,02) with a peak between day +7 (p = 0,001) and day +14 (p = 0,004) with further normalisation to baseline values on day +28 was found. Administration of glutamine did not significantly change neither the time trend nor the severity of D-xylose malabsorption, it decreased insignificantly the number of days with diarrhoea but decreased significantly the intensity of diarrhoea: 8.7 +- 11.1 episodes vs. 19.1 +- 17.6 episodes in the control group (p = 0.035).
No difference in D-xylose absorption, number of days or intensity of diarrhoea was found between different chemotherapeutic regimens. No statistical correlation of relative deterioration of D-xylose resorption on day +7 and diarrhoea after day 0 was found.
Conclusions: Intestinal resorption is compromised by cytostatic therapy for at least 2 weeks from the day of ASCT. No difference between particular chemotherapy regimens can be detected by the serum D-xylose test.
The mode and dosage of glutamine administration used in our study does not improve the resorptive capacity of intestine.