Columbia - Information - Summary of Medical Literature

Information

Summary of Medical Literature

Nutrition Supplements (14)

Fernandez C, Stutzer C. Alternative therapies in childhood cancer. New England Journal of Medicine 340(7); 569, 1999.

	Case Report

	In this letter to the editor the authors report on a child being treated for acute lymphoblastic leukemia. They states that the child's use of a mixture of naturopathic remedies reduced the bioavailability of oral mercaptopurine.

Copes M, Anderson R, Egeler R, Wolff J. Alternative therapies for the treatment of childhood cancer. New England Journal of Medicine 339(12);846, 1998.

	Case Report

	In this letter to the editor the authors report on a 15 year old boy diagnosed with stage IIA Hodgkins disease that refused therapy and pursued Matol Biomune OSF (astragalus, dairy colostrum and whey). The patient returned 4 months later with stage IIB Hodgkins. They also report on a 9 year old girl whose parents refused chemotherapy after a complete resection of a primitive neuroectodermal tumor. The parents decided to try shark cartilage instead. With chemotherapy adjuvant treatment survival was estimated at 50%. The girl died 4 months later.

Buiatti E, Arniani S, Verdecchia A, Tomatis L. Results from a historical survey of the survival of cancer patients given Di Bella multitherapy. Cancer 86:2143-9, 1999.

	Retrospective/Longitudinal Cohort Study

	The Ministry of Health in Italy conducted a retrospective analysis of patients who underwent the DiBella therapy (somatostatin, melatonin, beta-carotene, alpha-tocopherol, retinoic acid, bromocriptine, cyclophosphamide, vitamin D and ascorbic acid). 39 childhood leukemia patients who followed the Di Bella therapy in addition to standard treatment were compared to a control group (data from the Italian Cancer Registries). Survival for childhood leukemia patients who followed the Di Bella therapy was much lower then the controls. It was postulated that perhaps those that chose the Di Bella therapy were sicker or that they didn't follow their chemotherapy as well, but this wasn't studied directly.

Bode U, Hasan C, Hulsmann B, Fleischhack G. Recancostat compositum therapy does not prevent tumor progression in young cancer patients. Lin Padiatr 211: 353-355, 1999

	Single group intervention

	11 terminal pediatric oncology patients with solid tumors were offered Recancostat after standard therapy had failed. 40 mg/kg of Recancostat ( 200 mg reduced glutathione, 40 mg cysteine, 50 mg anthocyanes) was given orally for 1-30 weeks. The disease progressed in all patients and death occurred 1-48 weeks after starting the therapy. No side effects were seen with Recancostat oral administration.

Atkinson, SA, Halton, JM, Bradley, C, Wu, B, and Barr, RD. 1998. Bone and mineral abnormalities in childhood acute lymphoblastic leukemia: Influence of disease, drugs and nutrition. International Journal of Cancer. Suppl 11: 35-9.

	Prospective/Longitudinal Cohort Study.

	Fifty-six children with ALL and receiving treatment on Dana-Farber Cancer Institute (DFCI) protocols 87-001 or 91-001 were followed to evaluate physiological changes in mineral and bone metabolism. Plasma levels of 1, 25-dihydroxyvitamin D and osteocalcin were depressed in >70% and 73% of children at diagnosis, respectively, at diagnosis; 64% had hypercalciuria in the urine. During remission induction, high-dose steroids further reduced plasma osteocalcin. After six months of treatment, 64% of patients had severe reduction in bone mineral content; at 2 years follow-up 83% had radiographic evidence of osteopenia. Biochemical tests indicated that these results were likely to have occurred due to hypomagnesemia that had developed in 84% of the children (of whom 52% were hypermagnesuric) by the six-month mark. Dietary intake and absorption of magnesium were normal. In 10 children selected for supplementation with magnesium for up to 16-20 weeks, plasma magnesium reached normal levels in only 5.

Visani, G, Baravelli, S, Tosi, P, Manfroi, S, Remiddi, C, and Tura, S. 1997. Slimming diet and the development of acute leukemia: A possible relationship? Report of three cases. Leukemia and Lymphoma. 26(1-2): 191-3.

	Case series.

	Two of the three cases were female children. In both cases, the adolescents started personally designed slimming diets involving unbalanced dietary reduction (< 1,000 calories/day) without concomitant slimming drugs or micronutrient integration. Case 2: A 16-year-old female who was slightly overweight lost 10 kg over 8 months. She complained of increasing tiredness and migratory bone pain two months later and was subsequently diagnosed with ALL. Case 3: A 17-year-old female who was of normal weight lost 9 kg over 8 months. She then started complaining of asthenia and purpura appeared on her lower extremities. She was diagnosed with APL, treated with trans retinoic acid and daunomycin, achieved remission, and after consolidation therapy, underwent autologous bone marrow transplantation. She was in complete remission when she began the slimming diet again, 14 months later. Six months after initiation of the diet, she was diagnosed to have relapsed APL. The authors suggest a possible relationship between rapid weight loss diets, possibly depleting the body of micronutrients with antioxidant properties and the diagnosis of ALL or APL.

Malvy, DJ-M, Arnaud, J, Burtschy, B, Sommelet, D, Leverger, G, Dostalova, L, and Amedee-Manesme, O. 1997. Assessment of serum antioxidant micronutrients and biochemical indicators of nutritional status in children with cancer in search of prognostic factors. International Journal of Vitamin & Nutrition Research. 67(4): 267-71.

	See Above Reference.

Co-Q10

Iarussi D, Auricchio U, Agretto A, et al. Protective effect of coenzyme Q10 on anthracycline cardiotoxicity: control study in children with acute lymphoblastic leukemia and non-Hodgkin lymphoma. Molecular Aspects of Medicine 15 Suppl:S207-12, 1994.

	Controlled Trial.

	Results: 10 patients received coQ10 and 10 were controls. Both groups showed no difference in reduction of left ventricular shortening fraction, but only the control group had a decrease in the thickness of the septum wall. The authors concluded that there was a protective effect of CoQ10 on cardiac functioning during anthracycline therapy.

	1 article in Japanese.

Antioxidants-General

Malvy D, Arnaud J, Burtschy B, et al. Antioxidant micronutrients and childhood malignancy during oncological treatment. Medical and Pediatric Oncology 29:213-17, 1997.

	Observational, prospective study

	Results: Serum antioxidant levels were assessed in 157 children with various types of cancer before and after 6 months of treatment. Levels of alpha tocopherol, beta-carotene and retinol were low before treatment, when compared to 632 healthy control children. Levels remained low at 6 months. The study group was heterogeneous with respect to cancer diagnoses and anti-cancer treatment. No clinical outcomes were assessed.

Senturker S, Karahalil B, Inal M, Yilmaz H, Muslumanoglu H, Gedikoglu G, Dizdaroglu M. Oxidative DNA base damage and antioxidant enzyme levels in childhood acute lymphoblastic leukemia. FEBS Letters 416(3):286-90, 1997.

	Observational study

	Results: Higher levels of DNA base lesions and lower levels of the antioxidant enzymes glutathione peroxidase, catalase and superoxide dismutase were seen in patients with ALL as compared with a control group of disease-free children.

Vitamin A

Fiore, P, Castagnola, E, Marchese, N, Dufour, C, Garaventa, A, Mangraviti, S, Cornaglia-Ferraris, P. 1997. Retinol (vitamin A) and retinol-binding protein serum levels in children with cancer at onset. Nutrition. 13(1): 17-20.

	Case-Control Study (incident cases).

	The study included 54 children with newly diagnosed neoplasia (cases; 16 neuroblastomas, 22 other solid tumors, 9 lymphomas, and 7 leukemias) who were evaluated for plasma levels of Vitamin A, retinol-binding protein, and nutritional status at their cancer and compared with 47 healthy controls matched for sex and age. Significant differences existed between cases (mean Vitamin A plasma levels of 350 mg/L (95% CI 288-412) and retinol binding protein levels of 3.2 mg/dL (95% CI 2.6-3.9)) and controls (mean Vitamin A plasma levels of 517 mg/L (95% CI 471-563) and retinol binding protein levels of 4.9 mg/dL (95% CI 4.5-5.3)). Fifteen (28%) out of 54 cases were considered well nourished; 27/54 (50%) were considered at risk for malnutrition; 12 (22%) were malnourished. The authors conclude that although low Vitamin A and retinol-binding protein is a multi-faceted issue in children with cancer; it could be related to the metabolic changes that occur in the cancer patient. Dietary implications were ruled out in 67% of the sample.

Vitamin C

Halperin E, Gaspar L, George S, Darr D, et al. A double-blind, randomized, prospective trial to evaluate topical vitamin C solution for the prevention of radiation dermatitis. International Journal Radiation Oncology 26:413-6, 1993.

	Randomized Controlled Trial, double blind.

	Results: 65 patients, aged 1-76, with brain tumors applied topical ascorbic acid on one side of their head before and throughout radiation treatment. No discernible benefit was seen with vitamin C.

Helgestsad J, Pettersen R, Storm-Mathisen I, et al. Characterization of a new malignant human T-cell line (PFI-285) sensitive to ascorbic acid. European Journal of Haematology 44(1):9-17, 1990.

	Case report.

	Results: Tumor cells from a child with a unique form of malignant human T-cell line labeled PFI-285 were found to be extremely sensitive to ascorbic acid in culture. When only 50 micromol/L vitamin C were added to the cell culture, the malignant cells were killed.

Endresen L, Lie S, Storm-Mathiesen I, et al. Pharmacokinetics of oral 6-mercaptopurine: relationship between plasma levels and urine excretion of the parent drug. Therapeutic Drug Monitoring 12:227-34, 1990.

	Single group intervention.

	Results: 15 mg/kg vitamin C and 10 mg/kg glutathione were coadministered with 6-MP in 3 children with ALL. No consistent effect on the pharmacokinetics was observed.

Vitamin E

Helson L. The effect of intravenous vitamin E and menadiol sodium diphosphate on vitamin K dependent clotting factors. Thrombosis Research 35:11-8, 1984.

	Case study.

	Results: Two patients with disseminated neuroblastoma had a bleeding diathesis when the patients intravenously took 2300mg/m2 of vitamin E for four or more consecutive days. Blood prothrombin time and acclerated partial thromboplastin time were prolonged. Simultaneously, factors VII,IX, and X were lowered. When menadiol sodium diphosphate was given prior to vitamin E infusion these inhibiting effects were lessened.