Öz
Giriş: Çocuk kanser hastalarında beslenme bozukluğu sıklıkla görülür. Bu hastalarda beslenme durumlarının değerlendirilmesi çok önemlidir. En iyi yaklaşım bu çocuklarda iştahı arttırarak oral gıda alımını arttırmaktır. Kronik hastalığı olan çocuklarda siproheptadin ile iştah artışının uyarılmasını destekleyen bazı çalışmalar vardır. Bu çalışmada amacımız kanserli çocuklarda iştahı arttırarak oral gıda alımını arttırmak amacıyla kullandığımız siproheptadin ile ilgili deneyimimizi paylaşmaktır.Gereç ve Yöntem: İştah arttırmak için siproheptadin kullanan 14 hastanın dosyaları geriye dönük olarak incelendi. Tedavi başlangıcında, 4. ve 8. hafta vücut ağırlığı, boy, vücut kitle indeksi, yaşa göre ağırlık Z skorları, iştah durumu ve yan etkiler kayıt edildi.Bulgular: Siproheptadin yaşları 2,25 ile 16,5 arasında değişen median: 4,5 yıl 14 hastada kullanıldı. On bir hastada %78 4. ve 8. hafta ölçümlerde kilo artışı saptandı. Hastaların ilk ay ortalama ağırlık artışı 1,44 kg olarak bulundu p< 0,05 . Yaşa göre ağırlık Z skorları ortalaması -2,22’den -1,56’ya artış gösterdi p< 0,05 . İlaca bağlı ciddi yan etki bildirilmedi.Sonuç: Siproheptadin, kanserli çocuklarda özellikle kısa dönem kullanıldığında iştah ve vücut ağırlığı üzerinde olumlu etkileri olan, yan etkileri az bir iştah uyaranı gibi görünmektedir
Anahtar Kelimeler
Kaynakça
- 1. Pietsch JB, Ford C. Children with cancer: measurements of nutritional status at diagnosis. Nutr Clin Pract 2000;15:185-8.
- 2. Smith DE, Stevens MC, Booth IW. Malnutrition at diagnosis of malignancy in childhood: common but mostly missed. Eur J Pediatr 1991;150:318-22.
- 3. Ferguson M, Isenring E, Bauer J, Banks M, Capra S. An amendment to the 2002 A.S.P.E.N. Guideline Statements. Nutr Clin Pract 2009;23:658.
- 4. Mejia-Arangure JM, Fajardo-Gutierrez A, Reyes-Ruiz NI, Bernaldez-Rios R, Mejia Dominguez AM, Navarrete-Navarro S, et al. Malnutrition in childhood lymphoblastic leukemia: a predictor of early mortality during the induction-to-remission phase of the treatment. Arch Med Res 1999;30:150-3.
- 5. Reilly JJ, Odame I, McColl JH, McAllister PJ, Gibson BE, Wharton BA. Does weight for height have prognostic significance in children with acute lymphoblastic leukemia? Am J Pediatr Hematol Oncol 1994;16:225-30.
- 6. Viana MB, Murao M, Ramos G, Oliveira HM, de Carvalho RI, de Bastos M, et al. Malnutrition as a prognostic factor in lymphoblastic leukaemia: a multivariate analysis. Arch Dis Child 1994;71:304-10.
- 7. Coates TD, Rickard KA, Grosfeld JL, Weetman RM. Nutritional support of children with neoplastic diseases. Surg Clin North Am 1986;66:1197-212.
- 8. Yu LC, Kuvibidila S, Ducos R, Warrier RP. Nutritional status of children with leukemia. Med Pediatr Oncol 1994;22:73-7.
- 9. Hanigan MJ, Walter GA. Nutritional support of the child with cancer. J Pediatr Oncol Nurs 1992;9:110-8.
- 10. Nelson KA, Walsh D, Sheehan FA. The cancer anorexia-cachexia syndrome. J Clin Oncol 1994;12:213-25.
- 11. Levine AS, Brennan MF, Ramu A, Fisher RI, Pizzo PA, Glaubiger DL. Controlled clinical trials of nutritional intervention as an adjunct to chemotherapy, with a comment on nutrition and drug resistance. Cancer Res 1982;42:774-81.
- 12. Ottery FD. Supportive nutrition to prevent cachexia and improve quality of life. Semin Oncol 1995;22:98-111.
- 13. Couluris M, Mayer JL, Freyer DR, Sandler E, Xu P, Krischer JP. The effect of cyproheptadine hydrochloride (periactin) and megestrol acetate (megace) on weight in children with cancer/treatmentrelated cachexia. J Pediatr Hematol Oncol 2008;30:791-7.
- 14. Lavenstein AF, Dacaney EP, Lasagna L, Vanmetre TE. Effect of cyproheptadine on asthmatic children. Study of appetite, weight gain, and linear growth. JAMA 1962;180:912-6.
- 15. Epifanio M, Marostica PC, Mattiello R, Feix L, Nejedlo R, Fischer GB. A randomized, double-blind, placebo-controlled trial of cyproheptadine for appetite stimulation in cystic fibrosis. J Pediatr (Rio J) 2012;88:155-60.
- 16. Penfold JL. Effect of cyproheptadine and a multivitamin preparation on appetite stimulation, weight gain and linear growth. A clinical trial of 40 children. Med J Aust 1971;1:307-10.
- 17. Goldberg SC, Halmi KA, Eckert ED, Casper RC, Davis JM. Cyproheptadine in anorexia nervosa. Br J Psychiatry 1979;134:67-70.
- 18. Poomthavorn P, Mahachoklertwattana P, Khlairit P. Childhood virilization and adrenal suppression after ingestion of methandienone and cyproheptadine. J Pediatr Endocrinol Metab 2009;22:459-62.
- 19. Calka O, Metin A, Dülger H, Erkoç R. Effect of cyproheptadine on serum leptin levels. Adv Ther 2005;22:424-8.
- 20. Mahachoklertwattana P, Wanasuwankul S, Poomthavorn P, Choubtum L, Sriphrapradang A. Short-term cyproheptadine therapy in underweight children: effects on growth and serum insulin-like growth factor-I. J Pediatr Endocrinol Metab 2009;22:425-32.
Öz
Introduction: Malnutrition is frequently seen in pediatric cancer patients. It is very important to evaluate the nutritional status at diagnosis in these patients. The preferable method to treat cancer associated malnutrition in children is to increase their oral food intake with the help of stimulating their appetite. There are some studies supporting the use of appetite stimulants in patients with chronic illness. In this report, our aim is to share our experience with cyproheptadine as an appetite stimulant in children with cancer.Materials and Methods: The medical records of 14 children who were used cyproheptadine as an appetite stimulant were retrospectively evaluated. Their weight, height, body mass index, weight for age Z-score, appetite status and side effects were recorded at baseline, 4th week and 8th week.Results: Cyproheptadine was used in fourteen patients with a median age of 4.5 range:2.25-16.5 years . Eleven of them demonstrated a response to cyproheptadine average weight gain was 1.44 kg Mean weight-for-age z-score was increased from -2.22 to -1.56 p< 0.05 . No serious adverse events due to cyproheptadine were reported.Conclusions: It seems that cyproheptadine is a safe and effective agent to stimulate appetite and weight gain in children with cancer, particularly in short term usage
Anahtar Kelimeler
Kaynakça
- 1. Pietsch JB, Ford C. Children with cancer: measurements of nutritional status at diagnosis. Nutr Clin Pract 2000;15:185-8.
- 2. Smith DE, Stevens MC, Booth IW. Malnutrition at diagnosis of malignancy in childhood: common but mostly missed. Eur J Pediatr 1991;150:318-22.
- 3. Ferguson M, Isenring E, Bauer J, Banks M, Capra S. An amendment to the 2002 A.S.P.E.N. Guideline Statements. Nutr Clin Pract 2009;23:658.
- 4. Mejia-Arangure JM, Fajardo-Gutierrez A, Reyes-Ruiz NI, Bernaldez-Rios R, Mejia Dominguez AM, Navarrete-Navarro S, et al. Malnutrition in childhood lymphoblastic leukemia: a predictor of early mortality during the induction-to-remission phase of the treatment. Arch Med Res 1999;30:150-3.
- 5. Reilly JJ, Odame I, McColl JH, McAllister PJ, Gibson BE, Wharton BA. Does weight for height have prognostic significance in children with acute lymphoblastic leukemia? Am J Pediatr Hematol Oncol 1994;16:225-30.
- 6. Viana MB, Murao M, Ramos G, Oliveira HM, de Carvalho RI, de Bastos M, et al. Malnutrition as a prognostic factor in lymphoblastic leukaemia: a multivariate analysis. Arch Dis Child 1994;71:304-10.
- 7. Coates TD, Rickard KA, Grosfeld JL, Weetman RM. Nutritional support of children with neoplastic diseases. Surg Clin North Am 1986;66:1197-212.
- 8. Yu LC, Kuvibidila S, Ducos R, Warrier RP. Nutritional status of children with leukemia. Med Pediatr Oncol 1994;22:73-7.
- 9. Hanigan MJ, Walter GA. Nutritional support of the child with cancer. J Pediatr Oncol Nurs 1992;9:110-8.
- 10. Nelson KA, Walsh D, Sheehan FA. The cancer anorexia-cachexia syndrome. J Clin Oncol 1994;12:213-25.
- 11. Levine AS, Brennan MF, Ramu A, Fisher RI, Pizzo PA, Glaubiger DL. Controlled clinical trials of nutritional intervention as an adjunct to chemotherapy, with a comment on nutrition and drug resistance. Cancer Res 1982;42:774-81.
- 12. Ottery FD. Supportive nutrition to prevent cachexia and improve quality of life. Semin Oncol 1995;22:98-111.
- 13. Couluris M, Mayer JL, Freyer DR, Sandler E, Xu P, Krischer JP. The effect of cyproheptadine hydrochloride (periactin) and megestrol acetate (megace) on weight in children with cancer/treatmentrelated cachexia. J Pediatr Hematol Oncol 2008;30:791-7.
- 14. Lavenstein AF, Dacaney EP, Lasagna L, Vanmetre TE. Effect of cyproheptadine on asthmatic children. Study of appetite, weight gain, and linear growth. JAMA 1962;180:912-6.
- 15. Epifanio M, Marostica PC, Mattiello R, Feix L, Nejedlo R, Fischer GB. A randomized, double-blind, placebo-controlled trial of cyproheptadine for appetite stimulation in cystic fibrosis. J Pediatr (Rio J) 2012;88:155-60.
- 16. Penfold JL. Effect of cyproheptadine and a multivitamin preparation on appetite stimulation, weight gain and linear growth. A clinical trial of 40 children. Med J Aust 1971;1:307-10.
- 17. Goldberg SC, Halmi KA, Eckert ED, Casper RC, Davis JM. Cyproheptadine in anorexia nervosa. Br J Psychiatry 1979;134:67-70.
- 18. Poomthavorn P, Mahachoklertwattana P, Khlairit P. Childhood virilization and adrenal suppression after ingestion of methandienone and cyproheptadine. J Pediatr Endocrinol Metab 2009;22:459-62.
- 19. Calka O, Metin A, Dülger H, Erkoç R. Effect of cyproheptadine on serum leptin levels. Adv Ther 2005;22:424-8.
- 20. Mahachoklertwattana P, Wanasuwankul S, Poomthavorn P, Choubtum L, Sriphrapradang A. Short-term cyproheptadine therapy in underweight children: effects on growth and serum insulin-like growth factor-I. J Pediatr Endocrinol Metab 2009;22:425-32.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Research Article |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Eylül 2014 |
| Yayımlandığı Sayı | Yıl 2014 Cilt: 12 Sayı: 2 |