Plasma lipoproteins, triglycerides and glucose profile of cancer patients during bone marrow transplantation
Keywords:
child, adolescent, lipoproteins, triglycerides, bone marrow transplantationAbstract
The objective was to evaluate the nutritional metabolic profiles in children and adolescents with cancer
undergoing bone marrow transplants. Eighteen bone marrow transplantation patients were prospectively
evaluated from October 2003 to August 2004. The assessment was based on the biochemical blood analyses
of albumin, lipids and glucose at 3 different moments: before the bone marrow transplant, 7 days after the
bone marrow transplant and 14 days after the bone marrow transplant. The Friedman test was performed to
compare the distributions between the periods and the Mann’ Whitney test to compare differences in the
evolution between the bone marrow transplant groups: autologous versus allogeneic. Fifteen of the 18
patients were eligible: seven had leukemia, four lymphoma and four germ cell tumors. The mean age of the 15
patients was 10.7±7.1 years. Nine received autologous and six allogeneic-related bone marrow transplants;
two used cyclosporin A as an immunosuppressor and three total body irradiation as part of the conditioning
regimen. Thirteen of the 15 received parenteral nutrition. The length of stay was 33±14 days. The prevalence
of albumin and HDL-C deficits increased progressively during follow up: 15%, 31% and 46% and 54%, 69%
and 85%, respectively. The same result was observed with the glucose and triglyceride levels, showing a
progressive increase in the prevalence of abnormalities during bone marrow transplantation, with values of
7%, 43% and 50% and 31%, 69% and 77%, respectively. Total cholesterol and LDL-C levels above the normal
were only observed in one patient at the first moment (before the bone marrow transplant). The analysis of the
evolution of the variables during the three periods demonstrated that the HDL-C, glucose and triglyceride
levels changed significantly. No statistically significant differences were observed when comparing patients
submitted to allogeneic and autologous bone marrow transplants. However, changes in the HDL-C and
triglyceride levels were more accentuated in patients submitted to allogeneic bone marrow transplants. The
results suggested that metabolic and biochemical changes occur during the period of bone marrow
transplantation. These changes are probably multi-factorial, being associated with nutritional deficits, protein
catabolism and disturbances in the energy metabolism. It is probable that malnutrition, the use of parenteral
nutrition, as well as the inflammatory response to and toxicity of the drugs applied are implicated as causal
factors of these abnormalities.
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Copyright (c) 2023 Adriana GARÓFOLO, Patrícia Cláudia MODESTO, Letícia Navarro GORDAN, Antonio Sérgio PETRILLI, Adriana SEBER
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