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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

    Insights

    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.
    • 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.

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