Efectividad de la glutamina en nutrición parenteral en pacientes sometidos a trasplante de progenitores hematopoyéticos

Abstract

INTRODUCTION: hematopoietic stem cell transplantation (HSCT) is an aggressive and toxic procedure that can lead to malnutrition in patients. It has been proposed that these conditions may worsen under conditions of glutamine deficiency. AIM: the aim of this study is to analyze the effect of glutamine supplementation in parenteral nutrition (PN) for patients undergoing HSCT. MATERIAL AND METHODS: a retrospective observational study was conducted on patients who received PN following HSCT (both autologous and allo-HSCT) at our hospital between 2015 and 2020. The patients were divided into two groups: those who received glutamine and those who did not. Nutritional status, duration of PN, associated complications, hospital stay, mortality, and progression-free survival (PFS) at day +100 were analyzed. Data analysis was performed using the SPSS statistical software package. RESULTS: a total of 117 patients were included, 41.9 % of whom received glutamine supplementation in their PN. There were no significant differences in nutritional status or duration of PN between the two groups. Infections were more frequent in the glutamine group (p = 0.05). There were no significant differences between groups for other complications, although a subgroup analysis based on the type of conditioning showed a higher prevalence of diarrhea in the non-glutamine group of patients receiving reduced-intensity conditioning (p = 0.02). There were no significant differences in mortality, PFS, or duration of PN. Hospital stays were longer in the glutamine group (p = 0.026). CONCLUSIONS: in our study, patients receiving glutamine did not show an improvement in their nutritional status; they experienced more infections and had longer hospital stays. We suggest that glutamine supplementation should not be routinely recommended for PN in these patients.