Bradfield, S.M., Sandler, E., Geller, T., Tamura, R.N., & Krischer, J.P. (2015). Glutamic acid not beneficial for the prevention of vincristine neurotoxicity in children with cancer. Pediatric Blood and Cancer, 62, 1004–1010.
To determine if glutamic acid is an effective preventative therapy in children with vincristine-associated neurotoxicity
Before the first treatment of vincristine, patients were stratified into stratum 1 or stratum 2. Stratum 1 included patients with Wilms tumor or rhabdomyosarcoma who were to receive nine weeks of vincristine; stratum 2 included patients with acute lympoblastic leukemia or non-Hodgkin lymphoma who were to receive four weeks of vincristine. Both groups were randomized to receive L-glutamic acid hydrochloride or placebo three times a day until seven days after week 4 or week 9 of vincristine. The placebo was administered in the same manner.
A randomized, placebo-controlled, double-blind trial
Patients who received glutamic acid did not have significantly less neurotoxicity symptoms compared to the placebo group. The subgroup of patients aged 13 years or older experienced more benefits from glutamic acid (0.28, p = 0.055) compared to patients younger than 13 years. Neurotoxicity rated less than 0.02 (p = 1) but was not statistically significant.
Glutamic acid is not considered an effective preventative treatment of neurotoxicities in preadolescents.
Glutamic acid is not recommended for the prevention of neurotoxicities in pediatric patients at this time.