Related Experiment Videos
[Blood selenium content after conditioning and during the course of bone marrow transplantation in children with
1Klinik für Kinder- und Jugendmedizin, Friedrich-Schiller-Universität, Jena.
Insights
Children undergoing bone marrow transplantation (BMT) show low selenium levels and elevated glutathione peroxidase (Gpx) activity. Selenium supplementation is recommended to address this deficiency and monitor selenium status.
Area of Science:
- Biochemistry
- Oncology
- Pediatrics
Context:
- Bone marrow transplantation (BMT) is a critical procedure for treating malignant diseases in children.
- The conditioning phase prior to BMT involves intensive treatments like chemotherapy and irradiation.
- Nutritional status, particularly trace elements like selenium, can be significantly impacted by these aggressive therapies.
Purpose:
- To investigate the selenium status and related enzyme activity in pediatric patients undergoing BMT.
- To identify potential correlations between conditioning regimens and selenium levels.
- To establish recommendations for selenium supplementation and monitoring in this patient population.
Summary:
- Subnormal plasma and blood selenium levels were observed in 42 pediatric patients with malignant diseases at the end of the conditioning phase before BMT.
- Plasma glutathione peroxidase (Gpx) activity was markedly elevated, not reduced as in selenium deficiency, suggesting cytolytic processes.
- Combined conditioning (irradiation plus chemotherapy) resulted in significantly higher plasma Gpx values compared to chemotherapy alone.
- Elevated renal selenium excretion indicated potential tubular dysfunction during the observation period.
Impact:
- The findings highlight the necessity of selenium supplementation (at least 1-2 µg Se/kg/d) for patients undergoing BMT.
- Regular monitoring of plasma and blood selenium levels is crucial for optimizing patient care.
- Understanding selenium's role can inform supportive care strategies to mitigate treatment-related toxicities.
Patients And Results:
Prior to bone marrow transplantation (BMT), at the end of the conditioning phase, we found in 42 investigated children with malignant diseases subnormal lowered plasma- and blood selenium levels. Parallel to the diminished selenium status the plasma glutathione peroxidase activity (Gpx) was not reduced as it is in selenium deficiency, but markedly elevated and probably reflecting cytolytic processes. In the group of combined conditioning (fractionated total body irradiation plus chemotherapy) we found significantly more elevated plasma Gpx values in comparison to the only-chemotherapy group. The renal selenium excretion was elevated during the whole observation and could be caused by disturbed tubular function.
Conclusion:
We conclude, that in the situation of BMT a selenium substitution in a dosage of at least 1 to 2 micrograms Se/kg/d is necessary. Patients' selenium status should be monitored by analyses of plasma- and blood selenium contents.