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Trace Elements in Children with Acute Lymphoblastic Leukemia
Omid Reza Zekavat1, Mehran Karimi1, Fereshteh Majidi1
1Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Insights
Childhood acute lymphocytic leukemia (ALL) chemotherapy significantly decreases essential trace elements like zinc and copper. Monitoring and supplementation are crucial for managing treatment side effects and supporting children
Area of Science:
- Pediatric Oncology
- Clinical Chemistry
- Nutritional Science
Background:
- Chemotherapy for acute lymphocytic leukemia (ALL) in children can lead to malnutrition and altered serum trace elements.
- These alterations represent a significant challenge in managing childhood ALL.
- Understanding the impact of chemotherapy on trace elements is vital for supportive care.
Purpose of the Study:
- To investigate the changes in six key trace elements (Zinc, Copper, Manganese, Magnesium, Chromium, and Iron) in children with ALL.
- To evaluate these changes before and after induction chemotherapy.
- To consider age, gender, and chemotherapy protocol as potential confounding factors.
Main Methods:
- Atomic absorption spectrometry was used to assess trace element levels.
- Thirty-six newly diagnosed children with ALL were included in the study.
- Trace element concentrations were measured pre- and post-induction chemotherapy.
Main Results:
- A significant decrease in serum levels of Zinc, Copper, Manganese, Magnesium, and Iron was observed after induction chemotherapy.
- Chromium levels showed a significant decrease only in children younger than 10 and those receiving standard-risk chemotherapy.
- These findings were adjusted for confounding factors like age, gender, and chemotherapy protocol.
Conclusions:
- Induction chemotherapy in childhood ALL significantly depletes multiple essential trace elements.
- The results underscore the importance of complementary and supplementary nutritional management.
- Further research with larger cohorts and longer follow-up is needed to assess long-term effects on health and quality of life.
Objective:
Although combined chemotherapy regimen leads to 80% remission in children with acute lymphocytic leukemia (ALL), malnutrition and altered serum trace elements as a consequence of chemotherapy agents, have become the new issue to deal with. With the aim to evaluate each trace element in childhood ALL, we investiguâtes six main trace elements before and after induction chemotherapy while considering age, gender and chemotherapy protocol as confounding factors.
Methods:
Thirty-six newly diagnosed ALL children were recruited, and trace elements were assessed by atomic absorption spectrometry technique. Trace elements (Zinc, Copper, Manganese, Magnesium, Chromium and Iron) decreased significantly after induction chemotherapy.
Results:
Considering the confounding factors, mean difference of elements decreased significantly, except for Chromium. Its mean difference was only significant in children younger than 10 and those who had received standard risk chemotherapy.
Conclusion:
In conclusion, all the studied trace elements decreased significantly after induction chemotherapy session in ALL children. This highlights the importance of complementary and supplementary management. A larger cohort study with longer follow up is warranted to elucidate the long-term effect of chemotherapy on these trace elements on the general health status, quality of life or risk of relapse in ALL children.
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