Fatigue and Oxidative Stress in Children Undergoing Leukemia Treatment.

Journal Article (Journal Article)

Fatigue is a frequent and distressing symptom in children undergoing leukemia treatment; however, little is known about factors influencing this symptom. Antioxidants such as glutathione can decrease symptom severity in adult oncology patients, but no study has evaluated antioxidants' effects on symptoms in pediatric oncology patients. This study describes fatigue patterns and associations of fatigue with antioxidants represented by reduced glutathione (GSH) and the reduced/oxidized glutathione (GSH/GSSG) ratio among children receiving leukemia treatment. A repeated measures design assessed fatigue and antioxidants among 38 children from two large U.S. cancer centers. Fatigue was assessed among school-age children and by parent proxy among young children. Antioxidants (GSH and GSH/GSSG ratio) were assessed from cerebrospinal fluid at four phases during leukemia treatment. Young children had a steady decline of fatigue from the end of induction treatment through the continuation phase of treatment, but no significant changes were noted among the school-age children. Mean antioxidant scores varied slightly over time; however, the GSH/GSSG ratios in these children were significantly lower than the normal ratio. Mean GSH/GSSG ratios significantly correlated to fatigue scores of the school-age children during early phases of treatment. Children with low mean GSH/GSSG ratios demonstrated oxidative stress. The low ratios noted early in therapy were significantly correlated with higher fatigue scores during induction and postinduction treatment phases. This finding suggests that increased oxidative stress during the more intensive phases of therapy may explain the experience of fatigue children report.

Full Text

Duke Authors

Cited Authors

  • Rodgers, C; Sanborn, C; Taylor, O; Gundy, P; Pasvogel, A; Moore, IMK; Hockenberry, MJ

Published Date

  • October 2016

Published In

Volume / Issue

  • 18 / 5

Start / End Page

  • 515 - 520

PubMed ID

  • 27179013

Pubmed Central ID

  • PMC5279822

Electronic International Standard Serial Number (EISSN)

  • 1552-4175

International Standard Serial Number (ISSN)

  • 1099-8004

Digital Object Identifier (DOI)

  • 10.1177/1099800416647794


  • eng