Top

Published in:

01-04-2013 | Original Article

Antioxidant Levels at Diagnosis in Childhood Acute Lymphoblastic Leukemia

Authors: Nita Radhakrishnan, Veronique Dinand, Spriha Rao, Priyanka Gupta, G. S. Toteja, Manas Kalra, Satya Prakash Yadav, Anupam Sachdeva

Published in: Indian Journal of Pediatrics | Issue 4/2013

Abstract

Objective

To measure serum zinc, selenium, retinol and tocoferol levels at diagnosis of pediatric acute lymphoblastic leukemia (ALL) and to compare it to that of a control population. Correlation was made with episodes of febrile neutropenia during the first 8 wk of therapy.

Methods

Fasting levels of serum zinc, selenium, retinol and tocoferol were measured in 45 children diagnosed with acute lymphoblastic leukemia and in 20 healthy controls.

Results

Lower levels of baseline selenium and tocoferol were noted in patients who developed febrile neutropenia compared to the patients who did not (p = 0.022 and 0.026 respectively). Serum retinol was also lower in patients who developed sepsis when compared to those who did not.

Conclusions

Supplementation of antioxidants may be considered in clinical trials aiming at reducing infection related morbidity and mortality.

Ladas EJ, Jacobson JS, Kennedy DD, Teel K, Fleischauer A, Kelly KM. Antioxidants and cancer therapy: a systematic review. J Clin Oncol. 2004;22:517–28.PubMedCrossRef

Zuo XL, Chen JM, Zhou X, Li Z, Mei GY. Levels of selenium, zinc, copper and antioxidant enzyme activity in patients with leukemia. Biol Trace Elem Res. 2006;114:41–53.PubMedCrossRef

Kennedy DD, Tucker KL, Ladas ED, Rheingold SR, Blumberg J, Kelly KM. Low antioxidant vitamin intakes are associated with increases in adverse effects of chemotherapy in children with acute lymphoblastic leukemia. Am J Clin Nutr. 2004;79:1029–36.PubMed

D’Andrea GM. Use of antioxidants during chemotherapy and radiotherapy should be avoided. CA Cancer J Clin. 2005;55:319–21.PubMedCrossRef

Conklin KA. Chemotherapy-associated oxidative stress: impact on chemotherapeutic effectiveness. Integr Canc Ther. 2004;3:294–300.CrossRef

Block KI, Koch AC, Mead MN, Tothy PK, Newman RA, Gyllenhaal C. Impact of antioxidant supplementation on chemotherapeutic toxicity: a systematic review of the evidence from randomized controlled trials. Int J Cancer. 2008;123:1227–39.PubMedCrossRef

Ip C, Sinha DK. Enhancement of mammary tumorigenesis by dietary selenium deficiency in rats with a high polyunsaturated fat intake. Cancer Res. 1981;41:31–4.PubMed

Dasgupta J, Sanyal U, Das S. Vitamin E–its status and role in leukemia and lymphoma. Neoplasma. 1993;40:235–40.PubMed

Al-Tonbary Y, Al-Haggar M, El-Ashry R, El-Dakroory S, Azzam H, Fouda A. Vitamin E and N-acetylcysteine as antioxidant adjuvant therapy in children with acute lymphoblastic leukemia. Adv Hematol. 2009;2009:689639.PubMed

10.

Bhutta ZA, Black RE, Brown KH, Zinc Investigators’ Collaborative Group, et al. Prevention of diarrhea and pneumonia by zinc supplementation in children in developing countries: pooled analysis of randomized controlled trials. J Pediatr. 1999;135:689–97.PubMedCrossRef

11.

Yadav SP, Kalra M, Anjan M, Sachdeva A. Survival outcome in childhood acute lymphoblastic leukemia in India. Pediatr Blood Canc. 2010;54:178.CrossRef

12.

Bajel A, George B, Mathews V, et al. Treatment of children with acute lymphoblastic leukemia in India using a BFM protocol. Pediatr Blood Canc. 2008;51:621–5.CrossRef

13.

Kulkarni KP, Marwaha RK, Trehan A, Bansal D. Survival outcome in childhood ALL: experience from a tertiary care centre in North India. Pediatr Blood Canc. 2009;53:168–73.CrossRef

14.

Yadav SP, Dua V, Sachdeva A. Sepsis is a major barrier to improving survival in childhood acute lymphoblastic leukemia in the developing world. J Pediatr Hematol Oncol. 2011;33:636.PubMedCrossRef

15.

Hughes WT, Armstrong D, Bodey GP, et al. Guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Clin Infect Dis. 2002;34:730–51.PubMedCrossRef

16.

National Cancer Institute [Online]. Common Toxicity Criteria (CTC) Version 2.0 (1999). Available from URL http://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/ctcv20_4-30-992.pdf 1999.

17.

Möricke A, Reiter A, Zimmermann M; German-Austrian Swiss ALL-BFM study Group, et al. Risk-adjusted therapy of acute lymphoblastic leukemia can decrease treatment burden and improve survival: treatment results of 2169 unselected pediatric and adolescent patients enrolled in the trial ALL-BFM 95. Blood. 2008;111:4477–89.PubMedCrossRef

18.

Hann I, Vora A, Richards S, et al. Benefit of intensified treatment for all children with acute lymphoblastic leukaemia: results from MRC UKALL XI and MRC ALL97 randomised trials. UK Medical Research Council’s Working Party on Childhood Leukaemia. Leukemia. 2000;14:356–63.PubMedCrossRef

19.

Methodology developed by Simon Nelms, Application specialist, Thermofisher Scientific, U.K (personal communication).

20.

Bieri JG, Tolliver TJ, Catignani GL. Simultaneous determination of alphatocopherol and retinol in plasma or red cells by high pressure liquid chromatography. Am J Clin Nutr. 1979;32:2143–9.PubMed

21.

Mocchegiani E, Paolucci P, Granchi D, Cavallazzi L, Santarelli L, Fabris N. Plasma zinc level and thymic hormone activity in young cancer patients. Blood. 1994;83:749–57.PubMed

22.

Mikac-Dević M, Ferenec D, Tiefenbach A. Serum selenium levels in untreated children with acute lymphoblastic leukemia. J Trace Elem Electrolytes Health Dis. 1990;4:7–10.PubMed

23.

Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr. 1990;44:799–802.PubMed

24.

Malvy DJ, Arnaud J, Burtschy B, et al. Antioxidant micronutrients and childhood malignancy during oncological treatment. Med Pediatr Oncol. 1997;29:213–7.PubMedCrossRef

25.

Postovsky S, Arush MW, Diamond E, Elhasid R, Shoshani G, Shamir R. The prevalence of low selenium levels in newly diagnosed pediatric cancer patients. Pediatr Hematol Oncol. 2003;20:273–80.PubMed

26.

Beguin Y, Bours V, Delbrouck JM, et al. Relationship of serum selenium levels to tumor activity in acute non-lymphocytic leukemia. Carcinogenesis. 1989;10:2089–91.PubMedCrossRef

27.

Ozgen IT, Dagdemir A, Elli M, et al. Hair selenium status in children with leukemia and lymphoma. J Pediatr Hematol Oncol. 2007;29:519–22.PubMedCrossRef

28.

Fiore P, Castagnola E, Marchese N, et al. Retinol (vitamin A) and retinal-binding protein serum levels in children with cancer at onset. Nutrition. 1997;13:17–20.PubMedCrossRef

29.

Misaki K, Takitani K, Ogihara T, et al. Alpha-tocopherol content and alpha-tocopherol transfer protein expression in leukocytes of children with acute leukemia. Free Radic Res. 2003;37:1037–42.PubMedCrossRef

30.

Sgarbieri UR, Fisberg M, Tone LG, Latorre Mdo R. Nutritional assessment and serum zinc and copper concentration among children with acute lymphocytic leukemia: a longitudinal study. Sao Paulo Med J. 2006;124:316–20.PubMedCrossRef

31.

Prasad KN, Cole WC, Kumar B, Prasad KC. Scientific rationale for using high-dose multiple micronutrients as an adjunct to standard and experimental cancer therapies. J Am Coll Nutr. 2001;20:450S–63S.PubMed

32.

Lin LC, Que J, Lin LK, Lin FC. Zinc supplementation to improve mucositis and dermatitis in patients after radiotherapy for head-and-neck cancers: a double-blind, randomized study. Int J Radiat Oncol Biol Phys. 2006;65:745–50.PubMedCrossRef

Title: Antioxidant Levels at Diagnosis in Childhood Acute Lymphoblastic Leukemia
Authors: Nita Radhakrishnan
Veronique Dinand
Spriha Rao
Priyanka Gupta
G. S. Toteja
Manas Kalra
Satya Prakash Yadav
Anupam Sachdeva
Publication date: 01-04-2013
Publisher: Springer-Verlag
Published in: Indian Journal of Pediatrics / Issue 4/2013
Print ISSN: 0019-5456
Electronic ISSN: 0973-7693
DOI: https://doi.org/10.1007/s12098-012-0892-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Antioxidant Levels at Diagnosis in Childhood Acute Lymphoblastic Leukemia

Abstract

Objective

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 4/2013

Prevalence, Pattern and Outcome of Congenital Heart Disease in Bhabha Atomic Research Centre Hospital, Mumbai

Management of a Child with Vomiting

Dexmedetomidine in a Child with Methylphenidate Intoxication

Prevalence of Congenital Heart Disease

Approach to a Child with Upper Gastrointestinal Bleeding

Calcified Cerebral Cryptococcal Granuloma