1119 Glycyl-glutamine supplemention and high dose therapy

The amino acid, l-glutamine is the major energy substrate of the intestinal epithelium. Dietary supplementation reduces GI toxicity after RT and CT in animal models. The maximal insult to the gut occurs during high dose conditioning therapy and in this study glycyl-l-glutamine (GLG) supplementation is commenced one day before high dose therapy starts. In vitro testing showed minimal shifts in chemo or radiosensitivity with glutamine supplementation. This double blind randomised trial compares 50 g/day GLG iv supplementation versus an isonitrogenous mixture of aminoacids. Serum glutamine concs were doubled from a mean of 398 at baseline to 812 μmolar at end of infusion. GLG (19) Placebo (12) Median days to 0.5 neutrophils 14 16 Median days to 50 platelets 18 21 Median hospital stay post graft 19 (12–44) 22 (14–48) Mucositis score (nurse) 3.1 7.5 These results suggest a beneficial effect of GLG supplementation on gastrointestinal toxicity and haematological recovery with reduction in hospital stay and warrant further study.