Low antioxidant vitamin intakes are associated with increases in adverse effects of chemotherapy in children with acute lymphoblastic leukemia

Abstract

A large percentage of children undergoing treatment for acute lymphoblastic leukemia have inadequate intakes of antioxidants and vitamin A. Lower intakes of antioxidants are associated with increases in the adverse side effects of chemotherapy.

Dietary Supplement Use in Cancer Care: Help or Harm

“…Lower antioxidant intakes in a group of children with acute lymphocytic leukemia were associated with increases in adverse events during chemotherapy [77]. A decreased rate of chemotherapy-related nephro-and ototoxicity was only seen in the patients-supplemented with vitamins C, E, and selenium-who achieved the highest serum levels [78].…”

Antioxidant intake in paediatric oncology patients

“…Due to the limited data available to support the recommendation and level of dosing of antioxidants during cancer treatment, it leaves this topic in a state of controversy. Kennedy et al (11) advised that supplementation during treatment of antioxidants was not advocated due to the probable interference with cancer treatment, even though their study showed that the population group did not meet recommended dietary intake.…”

“…Bleomycin, mitomycin-C). (11,19,27) Other drug classes such as taxanes, vinca alkaloids, anti-folates and nucleosides only generate low levels of free radicals. (28) In contrast radiation's main therapeutic effect occurs indirectly via the ionization of water molecules in the cytoplasm to ROS for example superoxide and hydroxyl radicals.…”

“…(2,6,7) Although the importance and benefits of optimal nutritional status during treatment is known equally the dilemma lies in providing a sufficient or excessive intake of antioxidants that could compromise the efficacy of cancer treatment itself. (5,(8)(9)(10)(11)(12) Antioxidants have the potential to reverse the cancer treatment's action of increasing free radical production and killing cancer cells. (3) There are numerous adult studies showing the effects of antioxidants in cancer treatment however there are still very few in the paediatric population.…”

“…(20) Interestingly when higher plasma concentrations of Oxygen Radical Absorbance Capacity (ORAC), vitamin A, E, total carotenoids and 8-oxodeoxyguanosine were seen in children with Acute Lymphoblastic Leukaemia (ALL) a positive association was found with fewer infections improved quality of life, decreased toxicity and decreased length of admission. (4,7,11) Very few studies had investigated the role of selenium and zinc as antioxidants in the paediatric oncology setting. Studies that were available found that at diagnosis children had low serum selenium values except for those on corticosteroid treatment, who had raised selenium levels.…”