Stubblefield, M.D., Vahdat, L.T., Balmaceda, C.M., Troxel, A.B., Hesdorffer, C.S., & Gooch, C.L. (2005). Glutamine as a neuroprotective agent in high-dose paclitaxel-induced peripheral neuropathy: A clinical and electrophysiologic study. Clinical Oncology, 17, 271–276.

The study examined the neuroprotective effect of glutamine.

Seventeen patients received 10 g of glutamine administered three times daily for a total of four days beginning 24 hours after completion of paclitaxel. The remaining 29 patients made up the control group. Neurologic assessments and electrodiagnostic (nerve conduction) studies were carried out at baseline and at least two weeks (median 32 days) after treatment by a neurologist. Neurologic signs and symptoms also were assessed.

The study sample consisted of 46 patients who received high-dose paclitaxel prior to stem cell transplantation.

The study had a retrospective, non-randomized design.

Patients who received glutamine developed less weakness, less loss of vibratory sensation, and less toe numbness compared to those in the control group. A trend toward reducing symptoms of finger numbness was noted. In the comparison group, three patients developed foot drop and four patients developed tibialis weakness.

The mechanism of neuroprotection conferred by glutamine is unclear; some evidence suggests a correlation between treatment-induced reduction in nerve growth and severity of neurotoxicity.

The limitations of this study include it not being randomized or blinded as well as the fact that no placebo control group was used.

Results of this study should be interpreted with caution because of the small sample size and the non-randomized, retrospective design.