TY - JOUR
T1 - Predicting the neurobehavioral side effects of dexamethasone in pediatric acute lymphoblastic leukemia
AU - Warris, Lidewij T.
AU - van den Akker, Erica L T
AU - Aarsen, Femke K.
AU - Bierings, Marc B.
AU - van den Bos, Cor
AU - Tissing, Wim J E
AU - Sassen, Sebastiaan D T
AU - Veening, Margreet A.
AU - Zwaan, Christian M.
AU - Pieters, Rob
AU - van den Heuvel-Eibrink, Marry M.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Although dexamethasone is an effective treatment for acute lymphoblastic leukemia (ALL), it can induce a variety of serious neurobehavioral side effects. We hypothesized that these side effects are influenced by glucocorticoid sensitivity at the tissue level. We therefore prospectively studied whether we could predict the occurrence of these side effects using the very low-dose dexamethasone suppression test (DST) or by measuring trough levels of dexamethasone. Fifty pediatric patients (3–16 years of age) with acute lymphoblastic leukemia (ALL) were initially included during the maintenance phase (with dexamethasone) of the Dutch ALL treatment protocol. As a marker of glucocorticoid sensitivity, the salivary very low-dose DST was used. A post-dexamethasone cortisol level 2), and dexamethasone trough levels were measured during dexamethasone treatment. Patients with a hypersensitive response to dexamethasone had more behavioral problems (N = 11), sleeping problems, and/or somnolence (N = 12) (P
AB - Although dexamethasone is an effective treatment for acute lymphoblastic leukemia (ALL), it can induce a variety of serious neurobehavioral side effects. We hypothesized that these side effects are influenced by glucocorticoid sensitivity at the tissue level. We therefore prospectively studied whether we could predict the occurrence of these side effects using the very low-dose dexamethasone suppression test (DST) or by measuring trough levels of dexamethasone. Fifty pediatric patients (3–16 years of age) with acute lymphoblastic leukemia (ALL) were initially included during the maintenance phase (with dexamethasone) of the Dutch ALL treatment protocol. As a marker of glucocorticoid sensitivity, the salivary very low-dose DST was used. A post-dexamethasone cortisol level 2), and dexamethasone trough levels were measured during dexamethasone treatment. Patients with a hypersensitive response to dexamethasone had more behavioral problems (N = 11), sleeping problems, and/or somnolence (N = 12) (P
KW - Acute lymphoblastic leukemia
KW - Dexamethasone
KW - Dexamethasone suppression test
KW - Neurobehavioral problems
KW - Pediatrics
KW - Predictors
UR - http://www.scopus.com/inward/record.url?scp=84978743159&partnerID=8YFLogxK
U2 - 10.1016/j.psyneuen.2016.07.006
DO - 10.1016/j.psyneuen.2016.07.006
M3 - Article
C2 - 27448086
AN - SCOPUS:84978743159
SN - 0306-4530
VL - 72
SP - 190
EP - 195
JO - Psychoneuroendocrinology
JF - Psychoneuroendocrinology
ER -