Revealing the effects of glutamine and/or granulocyte stimulating factor on myelosupression and weight gain in rats exposing chemotherapy

Objectives: At the present time, administering intensive chemotherapy protocols in cancer management cause severe myelosupression. So, patients with cancer are risky for the development of several complications related with chemoterapy, such as neutropenic infections. In this experimental study, we investigated the effects of glutamine and/or granulocyte colony stimulating factor on myelosuppression and weight gain in rats exposing ifosfamideMaterials and methods: 33 rats were taken into this study. Complete blood counts and differantials of the rats were performed three times and the weight of the rats were measured every five days during the study. Group 1: The rats in the control group were fed with normal diet, Group 2: The rats in this group were fed with normal diet and also taken ifosfamide (125mg/kg), Group 3: The rats in this group were fed with normal diet and also taken ifosfamid (125mg/kg) and granulocyte colony stimulating factor (10µg/kg), Group 4: The rats in this group were fed with normal diet and with glutamine (0,5g/kg) and also taken ifosfamid (125mg/kg), Group 5: The rats in this group were fed with normal diet and with glutamine (0,5g/kg) and also taken ifosfamid (125mg/kg) and granulocyte colony stimulating factor (10µg/kg). Glutamine was given enterally before the administration of ifosfamide for 10 days and granulocyte colony stimulating factor was administered subcutaneously after the chemotherapy for eight days.Results: We could not find any significant positive effect of enteral glutamine, when the groups were compared in terms of the number of leucocyte, neutrophil, lymphocyte and monocyte and the ratio of the cytopenia on the third day of chemotherapy. Similarly there is no significant positive effect of glutamine on the number of leucocyte, neutrophil, lymphocyte and monocyte on the 8th of chemotherapy. When the cytopenia ratios of 8th day of the chemotherapy were evaluated, we could not find any positive effect of glutamine on leucopenia, neutropenia or monocytopenia ratios but the ratio of lymphopenia was lower in the group supported by glutamine after chemotherapy (group 4) when compared with the group exposing chemotherapy (group 2) alone.When the weights of the rats evaluated through the study, it was found that the mean weight for rats in the groups which were supported by glutamine before chemotherapy (group 4 and group 5) were higher than those in the other groups. We found that this positive effect of glutamine has disappeared in the group 4 after the cessation of glutamine.Conclusion: In this study, we found that glutamine amino acid which was given before the chemotherapy didn?t have any positive effect on the number of leucocytes, neutrophils or monocytes and also we could not found any additive effect between granulocyte colony stimulating factor and glutamine. On the otherhand, glutamine could have a positive effect in the recovery of lymphocytes after chemotherapy, for this reason new studies including higher number of subjects is needed. Additionally, our study showed that enterally glutamine which was given before chemotherapy may accelerate the weight gain. But it seems necessary to continue glutamine support simultaneously with chemotherapy, because of the diminishing of this positive effect after the glutamine cessation.