TY - JOUR
T1 - Glucocorticoids in the treatment of children with acute lymphoblastic leukemia and Hodgkin's disease
T2 - A pilot study on the adverse psychological reactions and possible associations with neurobiological, endocrine, and genetic markers
AU - Felder-Puig, Rosemarie
AU - Scherzer, Christiane
AU - Baumgartner, Michaela
AU - Ortner, Magdalena
AU - Aschenbrenner, Claudia
AU - Bieglmayer, Christian
AU - Voigtländer, Till
AU - Panzer-Grümayer, E. Renate
AU - Tissing, Wim J.E.
AU - Koper, Jan W.
AU - Steinberger, Karl
AU - Nasel, Christian
AU - Gadner, Helmut
AU - Topf, Reinhard
AU - Dworzak, Michael
PY - 2007/12/1
Y1 - 2007/12/1
N2 - Purpose: We did a controlled study to assess adverse psychological reactions (APR) associated with high-dose glucocorticoid therapy and tried to detect somatic correlates for the observed reactions. Patients and Methods: Our study included 37 patients with acute lymphoblastic leukemia (ALL) and 11 patients with Morbus Hodgkin (MH) disease, who were treated with high-dose glucocorticoid therapy, and 26 control patients with other types of malignancies. APRs were assessed with a standardized measure via parent-report. Patients with ALL and MH were further analyzed for signs of neuronal cell death in the cerebrospinal fluid, polymorphisms of the glucocorticoid receptor gene, as well as cortisol, adrenocorticorticotropic hormone, and dehydroepiandrosterone sulfate blood levels. Results: Fifty-four percent of ALL, 36% of MH, and 23% of control patients developed APR in the first few weeks of therapy. Approximately 3.5 months later, the majority of patients with ALL showed no APR, similar to control patients. Patients demonstrating a higher, nonsuppressible secretion of cortisol and/or adrenocorticorticotropic hormone during glucocorticoid therapy were found to be more likely to develop APR. No sign of neuronal cell destruction and no correlation of APR with specific glucocorticoid receptor polymorphisms were found. Conclusion: Our results suggest that the development of APR due to glucocorticoid therapy is measurable and correlates with hormonal reaction patterns.
AB - Purpose: We did a controlled study to assess adverse psychological reactions (APR) associated with high-dose glucocorticoid therapy and tried to detect somatic correlates for the observed reactions. Patients and Methods: Our study included 37 patients with acute lymphoblastic leukemia (ALL) and 11 patients with Morbus Hodgkin (MH) disease, who were treated with high-dose glucocorticoid therapy, and 26 control patients with other types of malignancies. APRs were assessed with a standardized measure via parent-report. Patients with ALL and MH were further analyzed for signs of neuronal cell death in the cerebrospinal fluid, polymorphisms of the glucocorticoid receptor gene, as well as cortisol, adrenocorticorticotropic hormone, and dehydroepiandrosterone sulfate blood levels. Results: Fifty-four percent of ALL, 36% of MH, and 23% of control patients developed APR in the first few weeks of therapy. Approximately 3.5 months later, the majority of patients with ALL showed no APR, similar to control patients. Patients demonstrating a higher, nonsuppressible secretion of cortisol and/or adrenocorticorticotropic hormone during glucocorticoid therapy were found to be more likely to develop APR. No sign of neuronal cell destruction and no correlation of APR with specific glucocorticoid receptor polymorphisms were found. Conclusion: Our results suggest that the development of APR due to glucocorticoid therapy is measurable and correlates with hormonal reaction patterns.
UR - http://www.scopus.com/inward/record.url?scp=37249083924&partnerID=8YFLogxK
U2 - 10.1158/1078-0432.CCR-07-0902
DO - 10.1158/1078-0432.CCR-07-0902
M3 - Article
C2 - 18056188
AN - SCOPUS:37249083924
SN - 1078-0432
VL - 13
SP - 7093
EP - 7100
JO - Clinical Cancer Research
JF - Clinical Cancer Research
IS - 23
ER -