La suplementación aguda con L-Arginina no previene la hematotoxicidad debida a la quimioterapia neoadyuvante en pacientes con cáncer de mama

Background: Breast cancer is the first cause of morbid-mortality from neoplasms among Mexican women. Neoadjuvant chemotherapy is the first curse of treatment for patients with locally advances disease; one of its main toxicities is myelosuppression. This can frequently cause the patient to delay her treatment or diminish the dosage. L-arginine can prevent this effect by maintaining a positive nitrogen balance and inducing the proliferation of hematopoietic cells. Objective: To evaluate the efficacy of the supplementation of L-arginine on the prevention of hematologic toxicity in patients with breast cancer undergoing neoadjuvant chemotherapy. response to neoadjuvant chemotherapeutic treatment. Materials and methods: We conducted a randomized clinical trial which administered 30 g of L-arginine in each chemotherapy cycle. We determined the values of hemoglobin, hematocrit, leucocytes and lymphocytes after each chemotherapy application. We permormed ANOVA tests in order to evaluate intragrupal changes along the antineoplastic treatment and t-student tests for independent samples for evaluating intergrupal differences. Results: 45 patients were assessed. All of them presented a significant decline in hematologic values each time. We did not find significant differences between groups. Conclusions: L-arginine supplementation does not prevent myelosuppression in patients with breast cancer undergoing neoadjuvant chemotherapy. More clinical trials are needs in order to obtain sufficient evidence that allows the recommendation (or not) of L-arginine as part of the integral treatment for the oncology patient.