Journal
JOURNAL OF PEDIATRIC HEMATOLOGY ONCOLOGY
Volume 30, Issue 11, Pages 791-797Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MPH.0b013e3181864a5e
Keywords
cancer; weight loss; wasting; weight gain; appetite stimulant
Categories
Funding
- H. Lee Moffitt Cancer Center CCOP Research Base
- Children's Oncology Group
- [U10 CA81920]
- [U10 CA098543]
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Background: Children with cancer frequently have associated cachexia and Malnutrition. Failure to thrive affects nearly, 40%, of oncology patients with advanced or progressive disease. Malnutrition can erode quality of life and adversely impact disease prognosis. Appetite stimulation and increased food intake is 1 approach to combat cancer-related cachexia. Materials and Methods: Cyproheptadine hydrochloride (CH), an appetite stimulant. was administered to children with cancer-associated cachexia to prevent further weight loss. All participants started CH and were evaluated for response after 4 weeks. Efficacy of megestrol acetate (MA) was evaluated in patients who did not respond to CH. Medical evaluation, weight measurements. preablumin, and serum leptin levels were preformed at follow-up visits. Results: Seventy patients were enrolled. Of the 66 evaluable patients. 50 demonstrated a response to CH (average weight gain 2.6 kg and mean weight-for-age z-score change of 0.35, P = 0.001). Seven of the 16 nonresponders received MA. Six patients completed 4 weeks of MA, 5 responded (average weight gain of 2.5 kg). The most commonly reported side effect of CH was drowsiness. One patient on MA developed low, cortisol levels and hyperlipidemia. Conclusions: This Study demonstrates that CH is a safe and effective way to promote weight gain in children with cancer/treatment-related cachexia.
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