TY - JOUR
T1 - L-carnitine supplementation for the treatment of fatigue and depressed mood in cancer patients with carnitine deficiency
T2 - A preliminary analysis
AU - Cruciani, R. A.
AU - Dvorkin, E.
AU - Homel, P.
AU - Culliney, B.
AU - Malamud, S.
AU - Shaiova, L.
AU - Fleishman, S.
AU - Lapin, J.
AU - Klein, E.
AU - Lesage, P.
AU - Portenoy, R.
AU - Esteban-Cruciani, N.
PY - 2004
Y1 - 2004
N2 - Nutritional factors are among the postulated causes of fatigue, a highly prevalent symptom in the cancer population, with serious impact on patients' quality of life. Deficiency of the micronutrient carnitine may play a role by reducing energy production through fatty acid oxidation. We present preliminary data of an open-label, dose-finding study to determine safety and maximally tolerated dose (MTD) of 1 week of L-carnitine supplementation in cancer patients with fatigue and carnitine deficiency. Patients who met inclusion/exclusion criteria underwent carnitine level determination. Eighty-three percent of these patients (15/18) had carnitine deficiency. Preliminary data analysis of 13 patients showed that total carnitine increased from 30.0 ± 6.9 to 41.0 ± 12.1 (mean ± SD) after 1 week of supplementation (P = 0.01), and free carnitine increased from 24.3 ± 6.1 to 33.8 ± 9.8 (P = 0.004). Outcome measures were fatigue (BFI score), depression (CES-D), sleep disruption (ESS), and performance status (Karnofsky). Median (min, max) BFI score at baseline was 73 (46, 82) versus 50 (3, 82) after 1-week supplementation (P = 0.009). CES-D score at baseline was 29 (16, 42) and 22 (8, 32) after 1 week (P = 0.028). ESS at baseline was 46.5 (0, 69) and 30.4 (0, 72) after 1 week (P = 0.015). Karnofsky score did not change significantly (P = 0.38). We are currently conducting a randomized, double-blind, placebo-controlled study to rigorously assess the role of L-carnitine for the treatment of fatigue and depression in cancer patients.
AB - Nutritional factors are among the postulated causes of fatigue, a highly prevalent symptom in the cancer population, with serious impact on patients' quality of life. Deficiency of the micronutrient carnitine may play a role by reducing energy production through fatty acid oxidation. We present preliminary data of an open-label, dose-finding study to determine safety and maximally tolerated dose (MTD) of 1 week of L-carnitine supplementation in cancer patients with fatigue and carnitine deficiency. Patients who met inclusion/exclusion criteria underwent carnitine level determination. Eighty-three percent of these patients (15/18) had carnitine deficiency. Preliminary data analysis of 13 patients showed that total carnitine increased from 30.0 ± 6.9 to 41.0 ± 12.1 (mean ± SD) after 1 week of supplementation (P = 0.01), and free carnitine increased from 24.3 ± 6.1 to 33.8 ± 9.8 (P = 0.004). Outcome measures were fatigue (BFI score), depression (CES-D), sleep disruption (ESS), and performance status (Karnofsky). Median (min, max) BFI score at baseline was 73 (46, 82) versus 50 (3, 82) after 1-week supplementation (P = 0.009). CES-D score at baseline was 29 (16, 42) and 22 (8, 32) after 1 week (P = 0.028). ESS at baseline was 46.5 (0, 69) and 30.4 (0, 72) after 1 week (P = 0.015). Karnofsky score did not change significantly (P = 0.38). We are currently conducting a randomized, double-blind, placebo-controlled study to rigorously assess the role of L-carnitine for the treatment of fatigue and depression in cancer patients.
KW - Cancer patients
KW - Carnitine deficiency
KW - Depression
KW - Fatigue
KW - L-carnitine
KW - Supplementation
UR - http://www.scopus.com/inward/record.url?scp=10644229911&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=10644229911&partnerID=8YFLogxK
U2 - 10.1196/annals.1320.016
DO - 10.1196/annals.1320.016
M3 - Article
C2 - 15591014
AN - SCOPUS:10644229911
SN - 0077-8923
VL - 1033
SP - 168
EP - 176
JO - Annals of the New York Academy of Sciences
JF - Annals of the New York Academy of Sciences
ER -
