Limits...
Efficacy of Enteral Supplementation Enriched with Glutamine, Fiber, and Oligosaccharide on Mucosal Injury following Hematopoietic Stem Cell Transplantation.

Iyama S, Sato T, Tatsumi H, Hashimoto A, Tatekoshi A, Kamihara Y, Horiguchi H, Ibata S, Ono K, Murase K, Takada K, Sato Y, Hayashi T, Miyanishi K, Akizuki E, Nobuoka T, Mizugichi T, Takimoto R, Kobune M, Hirata K, Kato J - Case Rep Oncol (2014)

Bottom Line: There were fewer days of diarrhea grade 3-4 in patients receiving GFO than in those who did not (0.86 vs. 3.27 days); the same was true for days of mucositis grade 3-4 (3.86 vs. 6.00 days).Other outcomes were not affected.We conclude that glutamine, fiber and oligosaccharide supplementation is an effective supportive therapy to decrease the severity of mucosal damage in HSCT.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology and Hematology, Sapporo Medical University School of Medicine, Sapporo, Japan ; Nutritional Support Team, Sapporo Medical University School of Medicine, Sapporo, Japan.

ABSTRACT
The combination of glutamine, fiber and oligosaccharides (GFO) is thought to be beneficial for alleviating gastrointestinal mucosal damage caused by chemotherapy. A commercial enteral supplementation product (GFO) enriched with these 3 components is available in Japan. We performed a retrospective study to test whether oral GFO decreased the severity of mucosal injury following hematopoietic stem cell transplantation (HSCT). Of 44 HSCT patients, 22 received GFO and 22 did not. Severity of diarrhea/mucositis, overall survival, weight loss, febrile illness/documented infection, intravenous hyperalimentation days/hospital days, engraftment, acute and chronic GVHD, and cumulative incidence of relapse were studied. Sex, age, performance status, diagnosis, disease status, and treatment variables were similar in both groups. There were fewer days of diarrhea grade 3-4 in patients receiving GFO than in those who did not (0.86 vs. 3.27 days); the same was true for days of mucositis grade 3-4 (3.86 vs. 6.00 days). Survival at day 100 was 100% in the GFO group, but only 77.3% for the patients not receiving GFO (p = 0.0091, log-rank test). Weight loss and the number of days of intravenous hyperalimentation were better in the GFO group (p < 0.001 and p = 0.0014, respectively). Although not significant, less gut bacterial translocation with Enterococcus species developed in the GFO group (p = 0.0728) than in the non-GFO group. Other outcomes were not affected. To the best of our knowledge, this is the first comparative clinical study of GFO supplementation to alleviate mucosal injury after allo-HSCT. We conclude that glutamine, fiber and oligosaccharide supplementation is an effective supportive therapy to decrease the severity of mucosal damage in HSCT.

No MeSH data available.


Related in: MedlinePlus

Overall survival.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4255989&req=5

Figure 1: Overall survival.

Mentions: Clinical outcomes are shown in table 2. There were no differences in the maximum diarrhea (p = 0.68) or mucositis (p = 0.20) grades. However, a statistically significant reduction in the number of days of diarrhea grade 3–4 (p = 0.001) or grade 2 (p = 0.0001) and days of mucositis grade 3–4 (p = 0.033) was apparent in the GFO-supplemented group. GFO administration also prevented weight loss (p < 0.001) and reduced the number of days of intravenous hyperalimentation (p = 0.001). There were no differences in the number of days with fever (>38.5 °C; p = 0.41) or microbiologically-documented infections (p = 0.71), all of which were bloodstream infections: 3 methicillin-resistant Staphylococcus aureus (MRSA) and 1 methicillin-resistant Staphylococcus epidermidis (MRSE) in the GFO group, and 2 Enterococcus faecium, 1 Enterococcus faecalis, 1 methicillin-resistant S. aureus, and 1 methicillin-resistant S. epidermidis in the group without GFO supplementation. GFO administration did not affect the number of hospital days (p = 0.88). Next, we analyzed the impact of GFO on clinical parameters of HSCT, especially the time to engraftment, incidence and severity of acute/chronicGVHD and relapse rate. We found no differences between the two groups in this respect (data not shown). However, an apparent benefit was observed in the GFO group regarding the survival rate 100 days after HSCT (100 vs. 77.3%, p = 0.0091, log-rank test) as shown in figure 1. There were 5 deaths during the first 100 days after HSCT in the group without GFO due to refractory disease in 2 cases, sepsis in 2 cases, and pneumonia in 1 case. Median survival time was 530 versus 416 days (p = 0.6871) in the GFO and non-GFO group, respectively.


Efficacy of Enteral Supplementation Enriched with Glutamine, Fiber, and Oligosaccharide on Mucosal Injury following Hematopoietic Stem Cell Transplantation.

Iyama S, Sato T, Tatsumi H, Hashimoto A, Tatekoshi A, Kamihara Y, Horiguchi H, Ibata S, Ono K, Murase K, Takada K, Sato Y, Hayashi T, Miyanishi K, Akizuki E, Nobuoka T, Mizugichi T, Takimoto R, Kobune M, Hirata K, Kato J - Case Rep Oncol (2014)

Overall survival.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4255989&req=5

Figure 1: Overall survival.
Mentions: Clinical outcomes are shown in table 2. There were no differences in the maximum diarrhea (p = 0.68) or mucositis (p = 0.20) grades. However, a statistically significant reduction in the number of days of diarrhea grade 3–4 (p = 0.001) or grade 2 (p = 0.0001) and days of mucositis grade 3–4 (p = 0.033) was apparent in the GFO-supplemented group. GFO administration also prevented weight loss (p < 0.001) and reduced the number of days of intravenous hyperalimentation (p = 0.001). There were no differences in the number of days with fever (>38.5 °C; p = 0.41) or microbiologically-documented infections (p = 0.71), all of which were bloodstream infections: 3 methicillin-resistant Staphylococcus aureus (MRSA) and 1 methicillin-resistant Staphylococcus epidermidis (MRSE) in the GFO group, and 2 Enterococcus faecium, 1 Enterococcus faecalis, 1 methicillin-resistant S. aureus, and 1 methicillin-resistant S. epidermidis in the group without GFO supplementation. GFO administration did not affect the number of hospital days (p = 0.88). Next, we analyzed the impact of GFO on clinical parameters of HSCT, especially the time to engraftment, incidence and severity of acute/chronicGVHD and relapse rate. We found no differences between the two groups in this respect (data not shown). However, an apparent benefit was observed in the GFO group regarding the survival rate 100 days after HSCT (100 vs. 77.3%, p = 0.0091, log-rank test) as shown in figure 1. There were 5 deaths during the first 100 days after HSCT in the group without GFO due to refractory disease in 2 cases, sepsis in 2 cases, and pneumonia in 1 case. Median survival time was 530 versus 416 days (p = 0.6871) in the GFO and non-GFO group, respectively.

Bottom Line: There were fewer days of diarrhea grade 3-4 in patients receiving GFO than in those who did not (0.86 vs. 3.27 days); the same was true for days of mucositis grade 3-4 (3.86 vs. 6.00 days).Other outcomes were not affected.We conclude that glutamine, fiber and oligosaccharide supplementation is an effective supportive therapy to decrease the severity of mucosal damage in HSCT.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology and Hematology, Sapporo Medical University School of Medicine, Sapporo, Japan ; Nutritional Support Team, Sapporo Medical University School of Medicine, Sapporo, Japan.

ABSTRACT
The combination of glutamine, fiber and oligosaccharides (GFO) is thought to be beneficial for alleviating gastrointestinal mucosal damage caused by chemotherapy. A commercial enteral supplementation product (GFO) enriched with these 3 components is available in Japan. We performed a retrospective study to test whether oral GFO decreased the severity of mucosal injury following hematopoietic stem cell transplantation (HSCT). Of 44 HSCT patients, 22 received GFO and 22 did not. Severity of diarrhea/mucositis, overall survival, weight loss, febrile illness/documented infection, intravenous hyperalimentation days/hospital days, engraftment, acute and chronic GVHD, and cumulative incidence of relapse were studied. Sex, age, performance status, diagnosis, disease status, and treatment variables were similar in both groups. There were fewer days of diarrhea grade 3-4 in patients receiving GFO than in those who did not (0.86 vs. 3.27 days); the same was true for days of mucositis grade 3-4 (3.86 vs. 6.00 days). Survival at day 100 was 100% in the GFO group, but only 77.3% for the patients not receiving GFO (p = 0.0091, log-rank test). Weight loss and the number of days of intravenous hyperalimentation were better in the GFO group (p < 0.001 and p = 0.0014, respectively). Although not significant, less gut bacterial translocation with Enterococcus species developed in the GFO group (p = 0.0728) than in the non-GFO group. Other outcomes were not affected. To the best of our knowledge, this is the first comparative clinical study of GFO supplementation to alleviate mucosal injury after allo-HSCT. We conclude that glutamine, fiber and oligosaccharide supplementation is an effective supportive therapy to decrease the severity of mucosal damage in HSCT.

No MeSH data available.


Related in: MedlinePlus