ArticleEuropean journal of cancer (Oxford, England : 1990)2010
Mechanisms of dexamethasone-induced disturbed sleep and fatigue in paediatric patients receiving treatment for ALL.
Article in European journal of cancer (Oxford, England : 1990), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 6 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 6 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Prevalence of symptoms in children with acute lymphoblastic leukaemia: a systematic review and meta-analysis.BMC cancer · 2023Pooled it
- Risk factors for steroid-induced adverse psychological reactions and sleep problems in pediatric acute lymphoblastic leukemia: A systematic review.Psycho-oncology · 2021Pooled it
- A systematic review of the association between fatigue and genetic polymorphisms.Brain, behavior, and immunity · 2017Pooled it
- Systematic review of the toxicity of short-course oral corticosteroids in children.Archives of disease in childhood · 2016Pooled it
- Recommendations for high-priority research on cancer-related fatigue in children and adults.Journal of the National Cancer Institute · 2013Guideline
- A systematic review of the association between immunogenomic markers and cancer-related fatigue.Brain, behavior, and immunity · 2012Pooled it
- Trial
- Reduced-dose dexamethasone premedication for weekly paclitaxel: a retrospective cohort study of early hypersensitivity reactions and steroid-related toxicity.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Unraveling Dexamethasone-Induced Neurobehavioral and Sleep Problems in Children With ALL: Which Determinants Are Important?JCO precision oncology · 2023Article
- Prevalence of Sleep Disturbances in Pediatric Cancer Patients and Their Diagnosis and Management.Children (Basel, Switzerland) · 2021Review
- Article
- The impact of maintenance therapy on sleep-wake rhythms and cancer-related fatigue in pediatric acute lymphoblastic leukemia.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2020Article
- Pharmacogenetics predictive of response and toxicity in acute lymphoblastic leukemia therapy.Blood reviews · 2015Review
- The effects of dexamethasone on sleep in young children with acute lymphoblastic leukemia.Sleep medicine · 2015Article
- Impairment in circadian activity rhythms occurs during dexamethasone therapy in children with leukemia.Pediatric blood & cancer · 2014Article
- Children's Oncology Group's 2013 blueprint for research: nursing discipline.Pediatric blood & cancer · 2013Review
- Use of actigraphy for assessment in pediatric sleep research.Sleep medicine reviews · 2012Review
- Sleep problems in children and adolescents with common medical conditions.Pediatric clinics of North America · 2011Review
- Sleep Disruption in Pediatric Cancer Survivors: Conceptual Framework and Opportunities for Clinical Assessment and Behavioral Treatment.American journal of lifestyle medicineReview
- Symptoms in Children Receiving Treatment for Cancer-Part I: Fatigue, Sleep Disturbance, and Nausea/Vomiting.Journal of pediatric oncology nursing : official journal of the Association of Pediatric Oncology NursesReview
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundDexamethasone contributes to high cure rates in paediatric acute lymphoblastic leukaemia (ALL) but significantly and adversely alters sleep and fatigue. Herein we explored three mechanisms (pharmacokinetics, serum albumin and pharmacogenetics) through which dexamethasone may cause debilitating fatigue and disrupted sleep.
methodsWe enrolled 100 patients on a 10-d study: 5-d of no dexamethasone (OFF DEX) followed by 5-d of dexamethasone (ON DEX) during continuation chemotherapy. Sleep variables were collected with continuous actigraphy on days 1 through 5, both OFF DEX and ON DEX. On days 2 and 5 of each 5-d period, parents and patients 7 years of age and older completed a sleep diary and Fatigue Scale questionnaire. Blood was collected at 0 (pre-dexamethasone), 1, 2, 4 and 8 h after the first oral dexamethasone dose for pharmacokinetic analysis. Serum albumin concentration was retrospectively analysed in stored samples. Patient DNA was genotyped for 99 polymorphic loci in candidate genes associated with glucocorticoid metabolism.
resultsDexamethasone clearance was significantly greater in younger patients than in older ones and in lower risk patients. In multiple regression models, risk group was significantly related to pharmacokinetic parameters. We found that polymorphisms in three genes (AHSG, IL6, POLDIP3) were significantly associated with sleep measures but not with fatigue.
conclusionRisk group had the most significant relationship with disrupted sleep in patients while on dexamethasone. Serum albumin levels had neither a direct relationship with sleep or fatigue variables nor an indirect relationship through systemic exposure to dexamethasone. We identified candidate genes that may help explain the adverse events of disrupted sleep in paediatric patients receiving dexamethasone.
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