化疗前后小儿实体瘤贫血模式——一项回顾性队列研究

The Pattern of Anemia in Pediatric Solid Tumors Prior to and after Chemotherapy- A Retrospective Cohort Study.

作者信息

Aron Tomal Barman, Roy Sagor Kumar, Mao Shuting, Li Bai, Richard Seidu A, Liu Yufeng

机构信息

Department of Pediatrics, First Affiliated Hospital of Zhengzhou University, Henan, Zhengzhou, 450000, PR. China.

Department of Neurology, First Affiliated Hospital of Zhengzhou University, Henan, Zhengzhou, 450000, PR. China.

出版信息

Curr Cancer Drug Targets. 2025;25(5):467-482. doi: 10.2174/0115680096292639240611050654.

DOI:10.2174/0115680096292639240611050654

PMID:38982695

Abstract

BACKGROUND

Solid pediatric tumors refer to cancers that affect children and adolescents, and they present unique challenges due to their distinct biological characteristics and their vulnerability to young patients. This study aims to shed light on addressing anemia and the causes of anemia in patients with solid pediatric tumors.

MATERIALS AND METHODS

This retrospective cohort comprised 200 healthy children as controls and 235 patients with solid tumors. The study was conducted at first Affiliated Hospital of Zhengzhou University between January 2020 and June 2023. We evaluated different parameters of blood components in controls and patients with solid tumors such as medulloblastoma, neuroblastoma, rhabdomyosarcoma, germ cell tumors, hepatoblastoma and nephroblastoma before and patients with only these tumors 3 weeks after the first cycle of chemotherapy. Further, we evaluated the relationship between serum ferritin and the weight of patients and assessed the relationship between anemia and metastasis to the bone marrow in patients with neuroblastoma and hepatoblastoma.

RESULTS

We observed various combinations of derangements in blood parameters such as hemoglobin, red blood cells, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, hematocrit, red cell distribution width, white blood cells, and platelet in medulloblastoma, neuroblastoma, rhabdomyosarcoma, germ cell tumors, hepatoblastoma and nephroblastoma before and 3 weeks after first cycle of chemotherapy. We found a significant correlation between serum ferritin levels and weight in neuroblastoma patients who are ≤ 2 years (p = 0.022). Involvement of tumor cells in bone marrow correlates with decreased Hb level in both neuroblastoma (CI = 93.21-106.68, p = 0.001) and hepatoblastoma (CI = 113.36-121.00, p = 0.001).

CONCLUSION

Anemia may manifest as an early symptom in neuroblastoma, hepatoblastoma, and nephroblastoma. Also, anemia may be worse in patients with neuroblastoma and hepatoblastoma after chemotherapy and might warrant anemia therapy.

摘要

背景

实体儿科肿瘤是指影响儿童和青少年的癌症，由于其独特的生物学特性以及年轻患者的易感性，它们带来了独特的挑战。本研究旨在阐明实体儿科肿瘤患者贫血及贫血原因的应对方法。

材料与方法

本回顾性队列研究纳入200名健康儿童作为对照，以及235名实体肿瘤患者。该研究于2020年1月至2023年6月在郑州大学第一附属医院进行。我们评估了对照组和实体肿瘤患者（如髓母细胞瘤、神经母细胞瘤、横纹肌肉瘤、生殖细胞肿瘤、肝母细胞瘤和肾母细胞瘤）化疗第一周期前及仅患有这些肿瘤的患者化疗第一周期后3周血液成分的不同参数。此外，我们评估了血清铁蛋白与患者体重之间的关系，并评估了神经母细胞瘤和肝母细胞瘤患者贫血与骨髓转移之间的关系。

结果

我们观察到髓母细胞瘤、神经母细胞瘤、横纹肌肉瘤、生殖细胞肿瘤、肝母细胞瘤和肾母细胞瘤化疗第一周期前及3周后血液参数（如血红蛋白、红细胞、平均红细胞体积、平均红细胞血红蛋白、平均红细胞血红蛋白浓度、血细胞比容、红细胞分布宽度、白细胞和血小板）出现各种紊乱组合。我们发现年龄≤2岁的神经母细胞瘤患者血清铁蛋白水平与体重之间存在显著相关性（p = 0.022）。肿瘤细胞累及骨髓与神经母细胞瘤（CI = 93.21 - 106.68，p = 0.001）和肝母细胞瘤（CI = 113.36 - 121.00，p = 0.001）患者的血红蛋白水平降低相关。