Chemotherapy-Induced Oxidative Stress in Pediatric Acute Lymphoblastic Leukemia

Introduction Plasma antioxidant capacity in children receiving chemotherapy decreases due to the effect of the disease and chemotherapy. Increased oxidative stress (OS) predisposes to an increased risk for chemotherapy-related toxicity and febrile neutropenic episodes. Materials and methods We condu...

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Published in:Curēus (Palo Alto, CA) CA), 2023-03, Vol.15 (3), p.e35968
Main Authors: Chaudhary, Preety, Kumari, Sweta, Dewan, Pooja, Gomber, Sunil, Ahmed, Rafat S, Kotru, Mrinalini
Format: Article
Language:English
Subjects:
Acids
Antioxidants
Bone marrow
Chemotherapy
Hematology
Leukemia
Lipid peroxidation
Lipids
Low income groups
Neutropenia
Oncology
Oxidation
Oxidative stress
Pediatrics
Plasma
Statistical analysis
Toxicity
Vitamin B
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Summary:Introduction Plasma antioxidant capacity in children receiving chemotherapy decreases due to the effect of the disease and chemotherapy. Increased oxidative stress (OS) predisposes to an increased risk for chemotherapy-related toxicity and febrile neutropenic episodes. Materials and methods We conducted this case-control study in the hematology-oncology unit of the department of pediatrics of a tertiary hospital in Delhi, India, from November 2017 to March 2019 to compare OS between children with acute lymphoblastic leukemia (ALL) and healthy controls. We estimated the trends in OS as measured by the plasma total antioxidant capacity (TAC) and thiobarbituric acid reactive substance (TBARS) levels at baseline and at the completion of induction I (four weeks), induction II (eight weeks), and induction IIA-consolidation (16 weeks) phases of chemotherapy in children with ALL. We also assessed the change in OS during different phases of initial treatment and studied the association between OS and the hematological toxicity of chemotherapy (determined by the need for blood component therapy and the number of febrile neutropenic episodes) and serum cobalamin and folate levels. Results OS was significantly higher in children with ALL at diagnosis (n=23) compared to controls (n=19). The median (interquartile range (IQR)) TAC levels (mM) were significantly lower (1.21 (1.05-1.26) versus 1.28 (1.26-1.32), P=0.006), and TBARS levels (nmol/mL) were significantly higher (312.0 (216.6-398.0) versus 58.5 (46.2-67.2), P
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.35968