The Relationship Of Corticosteroid Administration To Weight Gain In Children With Acute Lymphoblastic Leukemia In The Induction Phase At The Adam Malik Hajj Hospital Medan
The Relationship of Corticosteroid Administration to Weight Gain in Children with Acute Lymphoblastic Leukemia in the Induction Phase at the Adam Malik Hajj Hospital Medan
Introduction
Acute lymphoblastic leukemia (LLA) is a type of cancer that affects the blood and bone marrow, and it is the most common type of cancer in children. The treatment of LLA typically involves a combination of chemotherapy, radiation therapy, and stem cell transplantation. Corticosteroids, such as dexamethasone and prednisone, are commonly used in the induction phase of LLA treatment to help reduce the size of tumors and prevent the spread of cancer. However, the use of corticosteroids can have significant side effects, including weight gain and accumulation of fat in certain parts of the body.
Background
Corticosteroids, particularly glucocorticoid groups, have various important effects in cancer treatment, including vasoconstriction, anti-proliferation, anti-inflammatory, and immunosuppressant effects. These effects occur through corticosteroid interactions with glucocorticoid receptors that have been found in the type of leukemia, especially acute lymphoblastic leukemia (LLA). However, long-term use with high doses can have side effects, the most common of which is increased body weight and accumulation of fat in some parts of the body. Obesity is a significant problem for children with LLA because it can cause persistent leukemia, increase the risk of recurrence, and reduce the level of survival without poor events.
The importance of corticosteroids in chemotherapy therapy for the LLA induction phase, where drugs such as dexamethasone and prednisone are integral components, raises questions about their impact on the health of the patient's body, especially related to frequent weight gains. The use of corticosteroids in LLA treatment has been shown to have a significant impact on the body weight of children, with some studies suggesting that weight gain can occur as early as 1-2 weeks after the start of treatment.
Research Purposes
This study aims to determine the relationship between corticosteroid administration and weight gain in children who are undergoing the induction phase of LLA treatment. The study will investigate the effects of corticosteroid administration on body weight changes in children with LLA, and will examine the relationship between the use of prednisone and dexamethasone on body weight and nutritional status.
Research Methods
The study was conducted using an analytic-cross sectional design, where medical records of 62 child patients with LLA at Adam Malik Hospital Medan from 2015 to 2018 were analyzed. The data obtained were analyzed using various statistical tests, including the Wilcoxon test, Mann-Whitney test, and correlation test Spearman.
Research Results
The Wilcoxon test results showed that there was a significant effect of corticosteroid administration on body weight changes in the sample (p = 0.001). The Mann-Whitney test indicated a significant difference in the influence between the use of prednisone and dexamethasone on body weight (p = 0.001). However, there was no significant difference in the influence of the two drugs on the patient's nutritional status (p = 0.149). In addition, the Spearman correlation test showed that there was no significant relationship between weight gain and the total corticosteroid dose given (p = 0.251).
Conclusion
From the results of the study, it can be concluded that there is a relationship between corticosteroid administration and weight gain in children with LLA in the induction phase. There are differences in the influence between prednisone and dexamethasone on body weight, but there is no significant difference in the patient's nutritional status. In addition, observations show that weight gain is not directly related to the total corticosteroid dose given during the induction phase.
Additional Analysis and Explanation
The phenomenon of weight gain in patients who receive corticosteroids is a complex problem. This weight gain is not only related to fat accumulation, but also involves other factors such as changes in metabolism, fluid retention, and eating behavior. Children who undergo LLA treatment often face nausea and fatigue due to chemotherapy, which can affect their diet.
Dexamethasone, which tends to have a stronger potential than prednisone, is proven to have a greater influence on body weight. However, it is essential to note that although these two types of corticosteroids have similar side effects, proper management and strict monitoring are needed to minimize the negative impacts on patient health. Treatment that is lame between the effectiveness of cancer control and side effects on long-term growth and health children needs extra attention from the medical team.
Implications for Practice
Understanding the side effects of corticosteroids and proper management can help improve the quality of life of LLA patients, especially in terms of maintaining ideal weight during and after the treatment period. Healthcare providers should be aware of the potential for weight gain in children with LLA who are receiving corticosteroids, and should monitor their patients' weight and nutritional status closely. Additionally, healthcare providers should consider the use of alternative corticosteroids or dose adjustments to minimize the risk of weight gain and other side effects.
Limitations of the Study
This study had several limitations, including the small sample size and the use of medical records from a single hospital. Future studies should aim to recruit a larger sample size and collect data from multiple hospitals to increase the generalizability of the findings.
Future Research Directions
Future research should aim to investigate the long-term effects of corticosteroid administration on weight gain and nutritional status in children with LLA. Additionally, studies should examine the relationship between corticosteroid administration and other side effects, such as osteoporosis and cataracts.
Frequently Asked Questions (FAQs) about Corticosteroid Administration and Weight Gain in Children with Acute Lymphoblastic Leukemia
Q: What is the relationship between corticosteroid administration and weight gain in children with acute lymphoblastic leukemia (LLA)?
A: The study found a significant relationship between corticosteroid administration and weight gain in children with LLA in the induction phase. Corticosteroids, such as dexamethasone and prednisone, can cause weight gain and accumulation of fat in certain parts of the body.
Q: What are the potential side effects of corticosteroid administration in children with LLA?
A: The potential side effects of corticosteroid administration in children with LLA include weight gain, accumulation of fat in certain parts of the body, changes in metabolism, fluid retention, and eating behavior. Additionally, corticosteroids can cause other side effects, such as osteoporosis and cataracts.
Q: How do corticosteroids affect the body weight of children with LLA?
A: Corticosteroids can cause an increase in body weight in children with LLA due to fat accumulation and changes in metabolism. The study found that dexamethasone tends to have a stronger potential than prednisone to cause weight gain.
Q: What is the relationship between the use of prednisone and dexamethasone on body weight and nutritional status in children with LLA?
A: The study found that there was a significant difference in the influence between the use of prednisone and dexamethasone on body weight, but there was no significant difference in the influence of the two drugs on the patient's nutritional status.
Q: Is weight gain in children with LLA directly related to the total corticosteroid dose given?
A: The study found that there was no significant relationship between weight gain and the total corticosteroid dose given during the induction phase.
Q: How can healthcare providers minimize the negative impacts of corticosteroid administration on patient health?
A: Healthcare providers can minimize the negative impacts of corticosteroid administration on patient health by monitoring their patients' weight and nutritional status closely, considering the use of alternative corticosteroids or dose adjustments, and providing proper management and strict monitoring.
Q: What are the implications of this study for the treatment of children with LLA?
A: The study highlights the importance of monitoring the weight and nutritional status of children with LLA who are receiving corticosteroids, and considering the use of alternative corticosteroids or dose adjustments to minimize the risk of weight gain and other side effects.
Q: What are the limitations of this study?
A: The study had several limitations, including the small sample size and the use of medical records from a single hospital. Future studies should aim to recruit a larger sample size and collect data from multiple hospitals to increase the generalizability of the findings.
Q: What are the future research directions for this topic?
A: Future research should aim to investigate the long-term effects of corticosteroid administration on weight gain and nutritional status in children with LLA, and examine the relationship between corticosteroid administration and other side effects, such as osteoporosis and cataracts.