Academia de Genómica, Instituto Politécnico Nacional, CIIDIR-Unidad Durango, México.
Red Latinoamericana de Implementación y Validación de Guías Clínicas Farmacogenómicas (RELIVAF-CYTED).
Nutr Cancer. 2024;76(10):952-962. doi: 10.1080/01635581.2024.2378502. Epub 2024 Jul 12.
Acute lymphoblastic leukemia (ALL) is the most common childhood cancer in the world. Doxorubicin (Dox) is a very useful drug in these patients, however, one of the main adverse effects caused by the use of Dox is cardiotoxicity (CT). Protein-calorie malnutrition (PCM) is a factor that, among others, can influence the development of CT due to Dox. The aim of our study was to associate PCM as a risk factor for CT induced by Dox in Mexican children with ALL. We included 89 children with ALL who were treated with Dox, from October 2018 to July 2023, and of whom 14 developed some type of CT, 15 were underweight and 3 were overweight. The analysis of the association risk of CT due to PCM shows a statistically significant association of risk of developing CT due to PCM. On the other hand, healthy weight was associated with protection for developing CT due to Dox use. Of the total number of girls who presented CT, all had systolic dysfunction, while 6 of them also had diastolic dysfunction. On the other hand, of the total number of boys who presented CT, all of them had systolic dysfunction and only one of them also had diastolic dysfunction. These results show that in patients in which Dox is being administered, special attention is suggested for girls with PCM, since systolic failure is a precursor and occurs before diastolic failure in girls with PCM.
急性淋巴细胞白血病（ALL）是全球最常见的儿童癌症。多柔比星（Dox）在这些患者中是一种非常有用的药物，然而，使用 Dox 引起的主要不良反应之一是心脏毒性（CT）。蛋白质-能量营养不良（PCM）是除其他因素外，可能由于 Dox 导致 CT 的一个因素。我们的研究旨在将 PCM 作为与接受 Dox 治疗的墨西哥 ALL 儿童 CT 相关的危险因素进行关联。我们纳入了 2018 年 10 月至 2023 年 7 月期间接受 Dox 治疗的 89 名 ALL 儿童，其中 14 名出现了某种类型的 CT，15 名体重不足，3 名超重。对 PCM 导致 CT 的风险关联分析显示，PCM 导致 CT 的风险具有统计学显著关联。另一方面，健康体重与使用 Dox 导致 CT 的风险降低相关。在出现 CT 的女孩总数中，所有女孩均有收缩功能障碍，而其中 6 名女孩还有舒张功能障碍。另一方面，在出现 CT 的男孩总数中，所有男孩均有收缩功能障碍，而只有一名男孩还有舒张功能障碍。这些结果表明，在接受 Dox 治疗的患者中，建议对患有 PCM 的女孩给予特别关注，因为收缩功能衰竭是女孩出现 PCM 时舒张功能衰竭的前兆，而且先于舒张功能衰竭出现。
