RESUMO
CONTEXT AND OBJECTIVE: When undergoing chemotherapy and/or radiotherapy, children with acute lymphocytic leukemia may present important nutritional disorders because of the gastrointestinal toxicity of most chemotherapy agents or the effects of radiation on the organism. These patients may also present changes in their serum concentrations of trace elements such as zinc and copper. The present study aimed to follow anthropometric parameters and serum levels of zinc and copper in a group of children under treatment for acute lymphocytic leukemia. DESIGN AND SETTING: Longitudinal study, at the Pediatric Section of Hospital das Clínicas, Ribeirão Preto, Brazil. METHODS: Forty-five children with acute lymphocytic leukemia were studied. Anthropometric parameters such as weight and height and the daily intakes and serum levels of copper and zinc were recorded at diagnosis and during the treatment. RESULTS: During the initial phase of the treatment, there was an increase in energy intake accompanied by weight gain. However, during the later phases of treatment there was a reduction in energy intake with accompanying weight loss. Decreased growth rate during treatment was more pronounced in children with high-risk acute lymphocytic leukemia, probably due to radiation therapy. Serum zinc levels remained basically unaltered during the treatment, whereas copper levels decreased dramatically with the beginning of treatment. CONCLUSIONS: The treatment given to children with acute lymphocytic leukemia has an important effect on their linear growth rate and nutritional status, and also on their serum copper levels.
CONTEXTO E OBJETIVO: Crianças portadoras de leucemia linfóide aguda quando em tratamento quimioterápico e/ou radioterápico podem apresentar comprometimento do estado nutricional devido aos efeitos tóxicos a nível gastrointestinal dos agentes quimioterápicos ou aos efeitos da radioterapia sobre o organismo. Esses pacientes também podem apresentar alterações nas concentrações séricas de zinco e cobre. O objetivo foi acompanhar os parâmetros antropométricos e os níveis séricos de zinco e cobre de crianças em tratamento para leucemia linfóide aguda. TIPO DE ESTUDO E LOCAL: Estudo longitudinal, realizado no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, São Paulo, Brasil, que envolveu 45 crianças do Serviço de Oncologia pediátrica, portadoras de leucemia linfóide aguda. MÉTODOS: Medidas antropométricas como peso e altura, medidas de consumo alimentar, assim como níveis séricos de zinco e cobre foram avaliados ao diagnóstico e durante o tratamento. RESULTADOS: No início do tratamento, houve aumento na ingestão calórica, acompanhada de ganho de peso, no entanto, nas fases seguintes ao tratamento houve redução na ingestão alimentar, resultando em perda de peso. Diminuição na velocidade de crescimento foi notada nas crianças com leucemia linfóide aguda de alto risco que foram submetidas a radioterapia. Os níveis séricos de zinco não sofreram alterações durante o tratamento, já os níveis séricos de cobre tiveram importante diminuição em relação ao início do tratamento. CONCLUSÕES: Pudemos observar alterações no estado nutricional, assim como alterações nas concentrações séricas de micronutrientes durante o tratamento para leucemia linfóide aguda.
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Leucemia-Linfoma Linfoblástico de Células Precursoras , Cobre/sangue , Crescimento/efeitos dos fármacos , Avaliação Nutricional , Zinco/sangue , Leucemia-Linfoma Linfoblástico de Células Precursoras , Antropometria , Protocolos de Quimioterapia Combinada Antineoplásica , Tamanho Corporal/fisiologia , Ingestão de Energia , Estudos Longitudinais , Estado Nutricional , Fatores de Risco , Fatores de TempoRESUMO
CONTEXT AND OBJECTIVE: When undergoing chemotherapy and/or radiotherapy, children with acute lymphocytic leukemia may present important nutritional disorders because of the gastrointestinal toxicity of most chemotherapy agents or the effects of radiation on the organism. These patients may also present changes in their serum concentrations of trace elements such as zinc and copper. The present study aimed to follow anthropometric parameters and serum levels of zinc and copper in a group of children under treatment for acute lymphocytic leukemia. DESIGN AND SETTING: Longitudinal study, at the Pediatric Section of Hospital das Clínicas, Ribeirão Preto, Brazil. METHODS: Forty-five children with acute lymphocytic leukemia were studied. Anthropometric parameters such as weight and height and the daily intakes and serum levels of copper and zinc were recorded at diagnosis and during the treatment. RESULTS: During the initial phase of the treatment, there was an increase in energy intake accompanied by weight gain. However, during the later phases of treatment there was a reduction in energy intake with accompanying weight loss. Decreased growth rate during treatment was more pronounced in children with high-risk acute lymphocytic leukemia, probably due to radiation therapy. Serum zinc levels remained basically unaltered during the treatment, whereas copper levels decreased dramatically with the beginning of treatment. CONCLUSIONS: The treatment given to children with acute lymphocytic leukemia has an important effect on their linear growth rate and nutritional status, and also on their serum copper levels.
Assuntos
Cobre/sangue , Crescimento/efeitos dos fármacos , Avaliação Nutricional , Leucemia-Linfoma Linfoblástico de Células Precursoras/sangue , Zinco/sangue , Antropometria , Protocolos de Quimioterapia Combinada Antineoplásica , Tamanho Corporal/fisiologia , Criança , Pré-Escolar , Ingestão de Energia , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Estado Nutricional , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/fisiopatologia , Fatores de Risco , Fatores de TempoRESUMO
Context: Malnutrition in childhood cancer is commonly a serious problem. Changes in blood zinc and copper have also been found in malignant diseases. Objective: To describe the protein-energy nutritional status and serum zinc and copper of children with newly diagnosed leukemia. Design: Cross-sectional study. Setting: University referral center. Participants: 23 children with newly diagnosed acute lymphocytic leukemia (ALL) or acute non-lymphocytic leukemia (ANLL) between the ages of 1 and 10 years. The control subjects were 31 healthy school children of similar age from local schools. Main measures: Anthropometric measurements of height/age and weight/height, food intake and serum levels of zinc and copper. Results: Almost the entire group of children were eutrophic. Zinc and copper intake were below the recommended values. Serum zinc levels were significantly lower and serum copper levels were significantly higher in the leukemic group when compared to normal children. Conclusion: At the time of diagnosis the children suffering from leukemia were not overtly malnourished but blood analysis showed alterations in concentrations of the trace elements zinc and copper.