Abstract [eng] |
One of the most common complications of chemotherapy is intestinal damage (ID) as it alters drug absorption, increases the likelihood of bacteriema, disrupts enteral nutrition and microbiota. ID is one of the primary pathophysiological mechanisms contributing to the development of acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation (aHSCT). The study aimed to assess the extent of ID in children during the induction of acute lymphoblastic leukemia (ALL) and after aHSCT, identify biomarkers for the early diagnosis of ID, evaluate the impact of nutritional status and age on ID and biomarker levels. In the retrospective arm, health data were collected to determine changes in the nutritional status according to age during the ALL induction (2019-2022) and after aHSCT (2005-2016). A prospective analysis was conducted during 2020-2024. Blood samples (37 amino acids, urine, ammonia, neutrophil count, albumin, CRP) and stool calprotectin were collected, clinical status, degree of ID, and body mass index were assessed. The study offers a new perspective on the extent of ID during ALL induction and after aHSCT; defines risk factors for the development of ID, which can help to classify children into higher/lower risk groups for the development of ID; provides insights regarding the application of new biomarkers for diagnosing ID early; formulates dietary recommendations during chemotherapy treatment, highlighting the significance of enteral nutrition. |