الفهرس 
ACUTE LYMPHOBLASTIC LEUKEMIAOnly 14 pages are availabe for public view
 |  | from | 231 |  |  |
| | | from | 231 | | |
Abstract
This study was carried out during the period between June 2008 to March 2009 and included 40 patients with heamatological and solid tumors recruited from cases referred to the pediatric Hematology and Oncology unit, Children’s Hospital-Faculty of Medicine Ain Shams University. 20 patients of them served as a control group.
Glutamic acid group inclueded 16 patients had ALL, 2 NHL and 2 wilms’ tumor and control group inclueded 13 patients had ALL, 4 NHL and 3 wilms’ tumor.
Patients were subjected to full history taking with special stress on age, type of cancer ,chemotherapy taken with their doses, then complete physical and neurological examinations were carried out with special emphasis on special neurotoxicity record in order to monitor and to grade neurotoxical symptoms (Achilles & patellar reflexes, paresthesias, constipation, strength and mentation changes), laboratory assessment with adequate volume of venous blood was withdrawn from each patient and control for determination of liver , kidney functions and complete blood picture .
Statistical analysis was done to evaluate the different studied parameters in patients with hematological and solid tumors and their controls.
The aim of this study was to evaluate the probable side effects of Vincristine on haematological and solid tumors patients and to explore the value of glutamic acid to ameliorate these side effects in patients receiving repetitive doses of vincristine.
Patients in the treatment group received 1.5 mg glutamic acid daily p.o in three divided doses during the four-week induction chemotherapy program in which vincristine was given weekly with other chemotherapeutic agents.
The onset of neurotoxicity was significantly earlier in controls than in patients, as it progressed during follow up and became statistically significant in third visit regarding tendon Achilles reflex, the same pattern occurred in patellar reflex though was later.
Patients showed decreased frequency of sensory affection as regards parasthesia which was especially evident in the fourth visit compared to controls which started earlier in third visit.
Also controls showed increased frequency of constipation compared to patient’s reciving glutamic acid which was statistically significant in third visit.
Although there were no severe cases of strength, mentation changes affection in both groups which was statistically not significant.
On the other hand, glutamic acid was well tolerated by patients and did not affect the efficacy of VCR which was evident by our study that no gastrointestinal and heamatological affection in patients compared to controls.
In conclusion, our results suggest the possibility that glutamic acid administration may improve the tolerance of vincristine without producing adverse side effects. This study suggests that the co-administration of oral glutamic acid with repetitive intravenous bolus injections of vincristine resulted in a reduction of neurotoxicity, without diminishing the efficacy of the drug. It also decreases the need for dosage reductions. Gutamic acid, however, does not appear to have any effect on the gastrointestinal or hematological deterioration in patients being treated with vincristine.