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Small bowel function in acute lymphoblastic leukaemia.

A D Pearson, A W Craft, J V Pledger

    Archives of Disease in Childhood
    |May 1, 1984
    PubMed
    Summary
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    Acute lymphoblastic leukaemia treatment significantly impairs children's small bowel function, affecting nutrient and drug absorption. These findings highlight the need to monitor intestinal health during therapy.

    Area of Science:

    • Pediatric Oncology
    • Gastroenterology
    • Clinical Pharmacology

    Background:

    • Acute lymphoblastic leukaemia (ALL) treatment can cause significant side effects.
    • The impact of ALL treatment on pediatric small bowel function is not fully understood.
    • Understanding these effects is crucial for managing patient health and treatment efficacy.

    Purpose of the Study:

    • To assess small bowel function in children undergoing ALL treatment.
    • To investigate the relationship between treatment protocols and intestinal abnormalities.
    • To determine the prevalence of malabsorption and mucosal barrier dysfunction.

    Main Methods:

    • Studied 26 children with ALL before, during, and after treatment.
    • Utilized D-xylose absorption tests to evaluate carbohydrate absorption.

    Related Experiment Videos

  • Conducted permeability studies using mannitol and lactulose.
  • Assessed lactose malabsorption in a subset of patients.

    • Main Results:

    • Significant impairment of D-xylose absorption was observed during ALL treatment.
    • Permeability studies revealed decreased mannitol and increased lactulose concentrations.
    • Lactose malabsorption was present in 5 of 20 children, with 3 symptomatic.
    • Intestinal dysfunction was more pronounced with shorter (7-day) methotrexate intervals compared to longer (16-day) intervals.
    • Only 19% of children showed no abnormal small bowel function tests.

    Conclusions:

    • ALL treatment induces significant small bowel function abnormalities.
    • These abnormalities can lead to gastrointestinal symptoms, impaired mucosal barrier, and malabsorption.
    • Malabsorption affects nutrient intake and drug absorption, potentially causing malnutrition and suboptimal therapeutic drug concentrations.
    • Treatment-induced intestinal dysfunction has critical implications for pediatric cancer patient morbidity.