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Incidence of upper digestive tract inflammation in children with acute lymphoblastic leukemia at diagnosis
Xianmin Guan1,2,3, Xizhou An1,2,3, Jie Yu1
1Department of Hematology and Oncology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders Chongqing, China.
Insights
Most children with acute lymphoblastic leukemia (ALL) exhibit gastrointestinal inflammation at diagnosis. This inflammation, often in the stomach, is typically not caused by Helicobacter pylori infection.
Area of Science:
- Pediatric Gastroenterology
- Hematology-Oncology
- Clinical Endoscopy
Background:
- Gastrointestinal (GI) inflammatory lesions are frequent complications in pediatric acute lymphoblastic leukemia (ALL).
- The exact timing of the onset of these inflammatory lesions during ALL remains unclear.
- Understanding the prevalence and etiology of GI inflammation in ALL is crucial for patient management.
Purpose of the Study:
- To retrospectively analyze the prevalence and characteristics of upper digestive tract inflammatory lesions in children diagnosed with ALL.
- To investigate the potential causes of these lesions, including Helicobacter pylori (HP) infection.
Main Methods:
- Retrospective analysis of endoscopic findings in 129 children with ALL at the time of diagnosis.
- Documentation of lesion locations (esophagus, stomach, duodenal bulb) and presence of infections (HP, fungal).
Main Results:
- 82% (107/129) of children with ALL presented with GI inflammation at diagnosis.
- Gastric lesions were most common (101 patients), followed by duodenal bulb (51 patients) and esophageal lesions (11 patients).
- Helicobacter pylori infection was rare (2 patients), and only one case of esophageal mycotic infection was noted.
Conclusions:
- The majority of pediatric patients with ALL have significant upper GI inflammation upon diagnosis.
- Unlike in adult populations in China, HP infection is not a primary cause of these inflammatory lesions in children with ALL.
- Early endoscopic evaluation may be warranted for children with ALL to identify and manage GI inflammation.
Abstract:
Inflammatory lesions in upper digestive tract are common adversary events in children with acute lymphoblastic leukemia (ALL). However, when these lesions initiate is still not clear. In this study, we retrospectively analyzed the endoscopic detection results of 129 children who suffered from ALL at diagnosis. 107 (82%) patients were found with gastrointestinal inflammation, of which 101 patients had lesions in the stomach, 11 had lesions in the esophagus and 51 had lesions in the duodenal bulb. Only 2 patients were found with helicobacter pylori infection, and 1 patient was found with a mycotic infection in the esophagus. We demonstrate that most patients with ALL have gastrointestinal inflammation at the diagnosis of the basic disease, and in contrast to adult patients in China, these inflammatory lesions were mostly not caused by HP infection.
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