The Impact of Glutamine Mouthwash on Preventing Mucositis Following Administration of High Doses of Methotrexate in Children with Acute Lymphoblastic Leukemia: A Randomized Clinical Trial

Background: Acute lymphoblastic leukemia (ALL) represents the predominant childhood cancer. High-dose methotrexate is integral to leukemia treatment protocols. This study aimed to explore the efficacy of glutamine in preventing mucositis among leukemia patients undergoing high-dose methotrexate therapy.Method: This randomized clinical trial encompassed 45 patients (22 in the glutamine group and 23 in the placebo group). The intervention group was administered a glutamine mouthwash, while the control group received an identical placebo. Data analysis was performed using SPSS version 23, with a significance threshold set at P < 0.05.Results: No significant difference emerged between the groups concerning the incidence of nausea and vomiting; however, both groups observed a notable reduction in nausea frequency from the first to the fourth days (P = 0.0001 and P = 0.040, respectively). Grades III and IV mucositis were absent in both groups on the third and seventh days post-treatment. Furthermore, no significant difference was detected in mucositis improvement between the groups (P = 0.848).Conclusion: Glutamine mouthwash significantly reduced the incidence of nausea and vomiting, which are common chemotherapy complications. Moreover, up to 95% of patients were free from mucositis by the seventh-day post-chemotherapy.