Decrease of Postchemotherapy Complications With the Use of Probiotics in Children With Acute Lymphoblastic Leukemia

Area of Science:

• Pediatric Oncology
• Gastroenterology
• Microbiology

Background:

• Chemotherapy for acute lymphoblastic leukemia (ALL) can cause severe toxicities.
• These toxicities include gastrointestinal symptoms and infections, impacting patient quality of life and increasing healthcare utilization.
• Probiotics, like Lactobacillus rhamnosus GG, are being explored to mitigate these adverse effects.

Purpose of the Study:

• To evaluate the efficacy of Lactobacillus rhamnosus GG in reducing chemotherapy-induced gastrointestinal symptoms and complications in children with ALL.
• To compare the incidence of infections, antimicrobial use, emergency department visits, hospitalizations, and sepsis between probiotic and non-probiotic groups.

Main Methods:

• A prospective cohort study followed 60 children with ALL for 30 days post-chemotherapy discharge.
• Patients were randomized into two groups: 30 received Lactobacillus rhamnosus GG (group 1), and 30 did not (group 2).
• Gastrointestinal symptoms, infections, antibiotic use, emergency visits, hospitalizations, and sepsis were assessed.

Main Results:

• Gastrointestinal manifestations were significantly lower in the probiotic group (30%) compared to the control group (63%) (P=0.009).
• Antimicrobial use for suspected infections was lower in the probiotic group (26.6%) versus the control group (53.3%) (P=0.03).
• While not statistically significant, trends favored the probiotic group for reduced emergency room visits, hospitalizations, and sepsis.

Conclusions:

• Lactobacillus rhamnosus GG supplementation appears effective in improving gastrointestinal symptoms associated with chemotherapy in pediatric ALL patients.
• Probiotic use may reduce the incidence of infections and the need for antimicrobial agents.
• Further research could confirm the benefits in reducing hospitalizations and sepsis.