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[Renal function in children after treatment of acute lymphoblastic leukaemia (ALL)]
M Krawczuk-Rybak1, M Kuzmicz, K Kozlowska
1Klinika Onkologii Dzieciecej, Samodzielny Publiczny Dzieci cy Szpital Kliniczny, Akademia Medyczna, Waszyngtona 17, 15-274 Bialystok, Poland.
Insights
Children with acute lymphoblastic leukemia (ALL) show normal kidney function after intensive treatment, even with prior exposure to nephrotoxic drugs and varying methotrexate doses.
Area of Science:
- Pediatric Oncology
- Nephrology
- Pharmacology
Context:
- Acute lymphoblastic leukemia (ALL) treatment involves intensive chemotherapy, which can pose risks to renal function.
- Nephrotoxic medications and high-dose methotrexate are common in ALL protocols, necessitating careful monitoring of kidney health.
- Evaluating long-term renal outcomes in pediatric ALL survivors is crucial for assessing treatment-related toxicities.
Purpose:
- To assess renal function in children with ALL post-intensive therapy.
- To investigate the impact of nephrotoxic antibiotic exposure and varying methotrexate doses on renal parameters.
- To compare renal function markers between ALL patients and a healthy control group.
Summary:
- Serum cystatin C, creatinine, beta2-microglobulin levels, creatinine and cystatin C clearance, and urine osmolality were evaluated in 37 children with ALL post-treatment.
- No significant differences in renal function were observed between ALL patients and controls, or based on the number of nephrotoxic antibiotic exposures or methotrexate dosage.
- Renal function remained normal in ALL patients, irrespective of treatment intensity, specific drug exposures, or maintenance therapy status.
Impact:
- This study suggests that current intensive treatment protocols for pediatric ALL do not lead to significant long-term renal impairment.
- Findings support the safety of standard nephrotoxic antibiotic use and methotrexate dosing regimens in pediatric ALL management.
- Provides reassurance regarding renal health in ALL survivors, potentially reducing the need for extensive long-term renal monitoring in all cases.
Unlabelled:
The aim of the study was to evaluate the renal function (on the basis of serum: cystatin C, creatinine, beta2-microglobulin(B2M) levels, creatinine and cystatin C clearance, and urine osmolality) in 37 children with ALL (acute lymphoblastic leukaemia) after completing intensive treatment (9 in course of maintenance therapy), depending on nephrotoxic antibiotics use ( 3 times) and methotrexate dose (1.0 g/m2 vs 5g/m2). The control group was formed by 15 healthy children.
Results:
1) Serum cystatin C, creatinine, beta2-microglobulin levels creatinine and cystatin C clearance, and urine osmolality were similar in the analysed and control groups. 2) We did not find any differences between the analyzed parameters in the groups of children: a) in maintenance therapy and after the end of the therapy, b) received methotrexate in the dose of 5.0 g/m2 vs 1.0 g/m2, c) not treated children and treated
Conclusion:
The renal function is normal after completion of antileukaemic therapy in spite of previous use of nephrotoxic drugs.