Pediatric Hematology and Oncology, Ministry of Health Ankara City Hospital, 06110, Ankara, Turkey.
Support Care Cancer. 2021 Apr;29(4):2225-2230. doi: 10.1007/s00520-020-05688-3. Epub 2020 Sep 7.
We aimed to evaluate the impact of pretreatment folate and vitamin B deficiencies on the frequency of complications and peripheral blood recovery, in children with acute lymphoblastic leukemia (ALL).
Pre-induction serum folate and vitamin B levels of 88 newly diagnosed ALL patients were evaluated retrospectively. Folate < 3 ng/mL and vitamin B < 200 pg/mL were accepted as deficiency. Median hemoglobin, absolute neutrophil count (ANC), and platelet counts, transfusion needs, and complications such as mucositis, febrile neutropenia (FN), bleeding at diagnosis, at 15th and 33rd day of induction, were assessed. Recovery of peripheral blood count, which was defined as an ANC > 1.0 × 10/L and platelet count > 100 × 10/L at 33rd day of chemotherapy were also evaluated.
Folate or vitamin B deficiencies were observed in 21 (23%) and 40 (45%) children, respectively. Peripheral blood counts, complications rates, and transfusion needs were not statistically different between deficient and normal level groups during induction. The number of febrile days, though not statistically significant, was higher in the both deficient groups. Seventeen of 40 (42.5%) patients with vitamin B-deficient and 12 of 21 (57.1%) folate-deficient patients experienced at least one episode of FN during induction. FN was more common in folate-deficient group, but that was not statistically significant. Complete peripheral blood recovery at 33rd day of induction was seen in 40% in the vitamin B12-deficient group and 28.6% in folate-deficient group. Peripheral blood recovery rate at day 33 was also similar in both deficient and normal level groups.
Although pre-induction low serum levels of vitamin B and folate did not have statistically significant impact on disease-/treatment-related complications and peripheral blood recovery at induction, the frequency of FN and number of febrile day were higher in both deficiencies and folate-deficient patients, respectively.
我们旨在评估预处理叶酸和维生素 B 缺乏对儿童急性淋巴细胞白血病（ALL）并发症发生频率和外周血恢复的影响。
回顾性评估 88 例新诊断为 ALL 的患者诱导前血清叶酸和维生素 B 水平。叶酸＜3ng/mL 和维生素 B＜200pg/mL 被认为是缺乏。评估中位血红蛋白、绝对中性粒细胞计数（ANC）、血小板计数、输血需求以及并发症（如黏膜炎、发热性中性粒细胞减少症[FN]、诊断时、诱导第 15 天和第 33 天出血）。还评估了化疗第 33 天外周血计数的恢复情况，定义为 ANC＞1.0×10/L 和血小板计数＞100×10/L。
分别有 21 例（23%）和 40 例（45%）儿童存在叶酸或维生素 B 缺乏。在诱导期间，缺乏组和正常组之间的外周血计数、并发症发生率和输血需求没有统计学差异。虽然没有统计学意义，但两组缺乏组的发热天数更高。40 例维生素 B 缺乏症患者中有 17 例（42.5%）和 21 例叶酸缺乏症患者中有 12 例（57.1%）在诱导期间至少发生了一次 FN。叶酸缺乏组 FN 更常见，但无统计学意义。维生素 B12 缺乏组在诱导第 33 天完全恢复外周血的比例为 40%，叶酸缺乏组为 28.6%。缺乏组和正常组在第 33 天的外周血恢复率也相似。
尽管诱导前血清中维生素 B 和叶酸水平低与诱导时疾病/治疗相关的并发症和外周血恢复没有统计学上的显著影响，但在两种缺乏症和叶酸缺乏症患者中，FN 的频率和发热天数均较高。
