RESUMO
Most children with leukaemia are anaemic at diagnosis and at various times during treatment. Serum erythropoietin (EPO) was estimated in 27 children with acute leukaemia (n = 26) or lymphoma (n = 1) at diagnosis (n = 16), in relation to treatment with high-dose methotrexate (MTX, n = 11) or cytosine arabinoside (Ara-C, n = 8), and during oral maintenance therapy (n = 10). At diagnosis, in children with anaemia serum EPO was increased, and was inversely related to haemoglobin (Hb). After treatment with high-dose MTX, in some children serum EPO increased where Hb was unchanged or increased. After treatment with high-dose Ara-C, Hb declined, and serum EPO increased markedly in everyone. During oral maintenance therapy without significant anaemia, serum EPO was slightly increased in some children. In conclusion, children with leukaemia respond to anaemia with increased serum EPO concentration, but in relation to treatment with high-dose MTX and Ara-C, additional mechanisms may influence the EPO concentration.
Assuntos
Citarabina/uso terapêutico , Eritropoetina/imunologia , Leucemia Mieloide Aguda/sangue , Metotrexato/uso terapêutico , Leucemia-Linfoma Linfoblástico de Células Precursoras/sangue , Adolescente , Anemia/metabolismo , Criança , Pré-Escolar , Relação Dose-Resposta a Droga , Feminino , Hemoglobinas/metabolismo , Humanos , Lactente , Leucemia Mieloide Aguda/tratamento farmacológico , Leucemia Mieloide Aguda/epidemiologia , Estudos Longitudinais , Linfoma não Hodgkin/sangue , Linfoma não Hodgkin/tratamento farmacológico , Linfoma não Hodgkin/epidemiologia , Masculino , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiologiaRESUMO
A one year prospective study of all children under 15 years of age presenting for acute poisoning in Oslo is reported. There were 181 admissions in 179 children, of which 97 (54%) were boys, giving an annual incidence of 2.3%. All children survived without sequelae. Most poisonings were accidental and only two suicidal attempts were recorded. Of all poisonings 68 per cent occurred between the age of 1 and 2 years. The dominating toxic agents were drugs (44%), tobacco (22%) and petroleum products (9%). Most poisonings were mild and only 7 (4%) classified as severe. Seventy-two per cent of all children were admitted within the second hour after the ingestion of the toxic agent. Therapy should therefore be directed towards emptying the stomach with emetics or gastric lavage, unless corrosives or petroleum products are ingested. Childhood poisonings still call for better preventive measures since the toxic agent was found inappropriately stored in 86% of the accidental poisonings.
