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Adrenal Suppression in Children with Acute Lymphoblastic Leukemia

Strategic Insights

— 1 min read

Researchers at Aalborg University Hospital in Denmark conducted a study to investigate the frequency of adrenal function failure after corticosteroid therapy in children with acute lymphoblastic leukemia. The study, published in the Journal of Pediatrics, found that high-dose glucocorticoid therapy may cause adrenal suppression lasting more than one week, even after tapering the dose. The researchers suggest steroid replacement during stress episodes and testing adrenal function selectively in accordance with symptoms.

Key Takeaways:

  • The study found that adrenal suppression was present in 8 (47%) of 17 patients 5 days after a 5-week induction course of prednisolone and in 1 (20%) of 5 patients 7 days after a 3-week intensification course of dexamethasone.
  • Clinically significant manifestations of adrenal suppression were noted in 3 (12%) patients.
  • Of 204 scheduled tests, 131 were performed.
  • The researchers concluded that high-dose glucocorticoid therapy may cause adrenal suppression lasting more than one week in children with acute lymphoblastic leukemia.
  • They suggest steroid replacement during stress episodes within one to two weeks after discontinuation and testing adrenal function selectively in accordance with symptoms.
  • The study involved 24 children with acute lymphoblastic leukemia, who underwent low-dose adrenocorticotropic hormone tests before and after steroid courses and during infectious episodes.

Statistics:

  • 8 (47%) of 17 patients experienced adrenal suppression 5 days after a 5-week induction course of prednisolone.
  • 1 (20%) of 5 patients experienced adrenal suppression 7 days after a 3-week intensification course of dexamethasone.
  • 3 (12%) of 24 patients had clinically significant manifestations of adrenal suppression.
  • 131 (64%) of 204 scheduled tests were performed.
  • The study was conducted by researchers at Aalborg University Hospital in Denmark.

Sources:

  • Rix, M. et al. "Clinical impact of corticosteroid-induced adrenal suppression during treatment for acute lymphoblastic leukemia in children: A prospective observational study using the low-dose adrenocorticotropin test." Journal of Pediatrics, 2005;147(5):645-650.
  • Health & Medicine Week, 2006.
  • NewsRx.com via Health & Medicine Week.

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