L-ORNITHINE-L-ASPARTAT IN PROPHYLAXIS OF CHEMOTHERAPY-INDUCED MUCOSITIS IN PATIENTS WITH MULTIPLE MYELOMA

Abstract

Multiple myeloma is the second most common oncohematological malignancy in the world. The injury of gastrointestinal mucosal layer during the chemotherapy is caused by cytostatic effect of oncohematological medications. From the pathophysiological standpoint of multiple myeloma, the prophylaxis of chemotherapy-induced complications should include the agents that potentiate antioxidant defence.
 The objective of this study is to evaluate the effectiveness of L-Ornithine-L-Aspartate in preventing chemotherapy-induced mucositis in patients with multiple myeloma.
 Materials and Methods: Twenty-four patients diagnosed with multiple myeloma were included in the study. Two examinations were performed: one before starting chemotherapy and another after three courses of chemotherapy. Several biochemical markers were measured, including thiobarbituric acid reactive substances, catalase activity, and serum N-acetylneuraminic acid levels. The patients were divided into three groups: Group I (n=12) received chemotherapy alone, Group II (n=12) received L-Ornithine-L-Aspartate in addition to chemotherapy (10 g/day intravenously for 10 days, followed by 5 g twice a day for 20 days), and Group III (n=20) served as the control group comprising healthy individuals.
 Results and Discussion: Initial examinations revealed higher levels of thiobarbituric acid reactive substances in both Group I (1.19 times, p=0.0342) and Group II (1.3 times, p=0.021) compared to the control group. In Group I, the administration of chemotherapy resulted in a 1.58-fold increase in thiobarbituric acid reactive substances (p=0.0025) compared to the initial examination. However, in Group II, which received L-Ornithine-L-Aspartate as an adjuvant therapy, the second examination showed a 1.33-fold decrease in thiobarbituric acid reactive substances (p=0.0005) compared to Group I.
 Conclusion. Inclusion of L-ornithine-L-aspartate to adjuvant therapy during the conduction of chemotherapy provides decrease in severity of chemotherapy-induced oxidative stress and alleviates the severity of chemotherapy-induced mucositis.