Evaluation of Adrenal Reserve in Children with Acute Lymphocytic Leukemia Treated with Prednisone or Dexamethasone
Contribuinte(s) |
UNIVERSIDADE DE SÃO PAULO |
---|---|
Data(s) |
05/11/2013
05/11/2013
2012
|
Resumo |
Background/Aims: The purpose of this study was to compare adrenal gland reserve in acute lymphocytic leukemia (ALL) patients 8 weeks after treatment with either prednisone (PRED) or dexamethasone (DEX) during the induction phase of therapy. Methods: A double-blind comparative study of patients treated with PRED and DEX was performed. Sixteen patients received PRED (40 mg/m(2)/day) and 13 patients received DEX (6 mg/m(2)/day), both for 28 days. A low-dose adrenocorticotropic hormone test (1.0 mu g/m(2), IV) was performed before and weekly for 8 weeks after abrupt cessation of glucocorticoid therapy. Sixteen children without ALL were used as controls to determine the cutoff peak cortisol level (14.2 mu g/dl). Results: Both groups (PRED and DEX) displayed similar mean peak cortisol levels before treatment and during the 8 weeks of evaluation (p = 0.652). No relationship was observed between the incidence of infection/stress and peak cortisol level within each group, nor was there a difference in the frequency of infection/stress between groups (p = 0.359). Although the patients presented variations in peak cortisol during the study period, no signs or symptoms of adrenal insufficiency were observed. Conclusion: Patients who received PRED or DEX for 4 weeks showed similar adrenal reserves and infection rates for 8 weeks after abruptly stopping glucocorticoid therapy, suggesting that DEX, which is a better antileukemic drug than PRED, has similar adrenal suppression and recovery rates. Copyright (c) 2012 S. Karger AG, Basel Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) |
Identificador |
HORMONE RESEARCH IN PAEDIATRICS, BASEL, v. 78, n. 2, supl. 1, Part 2, pp. 73-80, 40969, 2012 1663-2818 http://www.producao.usp.br/handle/BDPI/41891 10.1159/000339830 |
Idioma(s) |
eng |
Publicador |
KARGER BASEL |
Relação |
HORMONE RESEARCH IN PAEDIATRICS |
Direitos |
closedAccess Copyright KARGER |
Palavras-Chave | #ADRENAL RESERVE #ADRENOCORTICOTROPIC HORMONE #ACUTE LYMPHOCYTIC LEUKEMIA #PREDNISONE #DEXAMETHASONE #ACUTE LYMPHOBLASTIC-LEUKEMIA #GLUCOCORTICOID THERAPY #ADRENOCORTICOTROPIN TEST #REMISSION-INDUCTION #CEREBROSPINAL-FLUID #MENINGEAL LEUKEMIA #ACTH TEST #RECOVERY #SUPPRESSION #HORMONE #ENDOCRINOLOGY & METABOLISM #PEDIATRICS |
Tipo |
article original article publishedVersion |