Positive Health Online

Abstract

GORINGE and colleagues, Department of Haematology, University Hospital of Wales, College of Medicine, Cardiff, UK write that hepatic (liver) veno-occlusive disease (VOD) of the liver is a common complication following administration of high-dose cytotoxic therapy for bone marrow transplantation (BMT).

Background

Methodology

The injury to the liver is thought to occur from free radical damage to endothelial cells of the sinusoids and small hepatic veins. Following chemotherapy, glutathione, the main antioxidant becomes depleted . Animal studies have demonstrated that infusions of glutamine can maintain glutathione levels and protect against injury from free radicals.

Results

The authors present two cases of established VOD which were successfully treated with intravenous glutamine and oral vitamin E. The authors state that although both cases have possible confounding factors, they believe that the data support the hypothesis that glutamine/vitamin E have a role in the prophylaxis and treatment of VOD.

Conclusion

Further formal clinical trials are required.

References

Goringe AP et al. Glutamine and vitamin E in the treatment of hepatic veno-occlusive disease following high-dose chemotherapy. Bone Marrow Transplant 21(8): 829-32. Apr 1998.

Comment

It is encouraging that nutritional support using glutamine and vitamin E can help to mitigate certain of the serious and potentially life-threatening effects of chemotherapy and immunotherapy involved in bone marrow transplantation. Cancer patients are so often placed in a position between a rock and hard place; frequently the only options offered to patients are these extremely radical and aggressive treatments, which, if they work, can save their life, and if not, can lead to a most miserable death.