A novel non-invasive biomarker for assessment of small intestinal mucositis in children with cancer undergoing chemotherapy
Date
2006
Authors
Tooley, K.
Saxon, B.
Webster, J.
Zacharakis, B.
McNeil, Y.
Davidson, G.
Butler, R.
Editors
Advisors
Journal Title
Journal ISSN
Volume Title
Type:
Journal article
Citation
Cancer Biology and Therapy, 2006; 5(10):1275-1281
Statement of Responsibility
Tooley, Katie L ; Saxon, Ben R ; Webster, Judy ; Zacharakis, Betty ; McNeil, Yvette ; Davidson, Geoffrey P ; Butler, Ross N
Conference Name
Abstract
Background: Small intestinal mucositis is a common side-effect following high-dose chemotherapy, causing patients to experience pain and abdominal complications often leading to extended stays in hospital. A biomarker to detect these small intestinal changes does not exist in clinical practice. This study aimed to assess the non-invasive 13C-Sucrose breath test (SBT) to detect small intestinal damage associated with mucositis in pediatric cancer patients having chemotherapy. Patients and Methods: Small intestinal function was assessed in 15 pediatric cancer patients and 26 healthy children. Subjects were studied for small intestinal permeability (SIP; lactulose/rhamnose), digestive and absorptive capacity (SBT; sucrose), and oro-cecal transit time (OCTT; lactulose), by ingesting two sugar drinks containing the respective sugars. Combined tests were carried out at baseline, day1, day3-5 and day6-9, and in healthy individuals on two separate occasions. A total of 25 cycles of chemotherapy were assessed. Breath samples for the SBT were collected every 15min for 3 h (expressed as % cumulative dose at 90min (CD)), a 5 h urine collection for SIP and breath hydrogen determined every 30min for 3 h for OCTT. Results: Clinical mucositis occurred in seven of the 25 cycles of chemotherapy (28%). No significant difference was observed for SIP and OCTT. The SBT %CD at 90min was significantly lower in the mucositis group compared to the unaffected group and controls at baseline (p < 0.05). Patients who developed mucositis maintained a significantly lower %CD, for all test points (p < 0.05) compared to the unaffected patients. In patients who developed mucositis the SBT was below the reference range of the controls at all time points. Conclusion: The findings show for the first time that it is possible to non-invasively detect and monitor gut damage associated with chemotherapy-inducedmucositis in pediatric cancer patients.