The Correlation between chemotherapy agents and alopecia in childhood acute lymphoblastic leukemia at Dr. Mohammad Hoesin General Hospital Palembang
Keywords:
Alopecia, Acute lymphoblastic leukemia, Chemotherapeutic agents, ChildhoodAbstract
Background Alopecia is the most common side effect of chemotherapy agents via disruption of metabolic growth and mitotic processes of hair follicles, leading to shaft damage and hair loss. Alopecia may cause psychological and social problems. Â Methods A cross-sectional descriptive study was conducted in pediatric Hemato-Oncology clinic and wards of RSMH from February to March 2023. Sixty patients were selected using purposive sampling. Medical records, chemotherapy protocol, and questionnaires were obtained. Alopecia was diagnosed clinically and using visual aid. Â Results Out of 60 patients, 39 were boys and 21 were girls. Subjects were predominantly 6-11 years old (46.7%), acute lymphoblastic leukemia (ALL) standard risk (55.0%), and phase maintenance I chemotherapy (48.3%). Common patterns of alopecia were frontal (18.5%) and vertex (18.1%). Methotrexate, vincristine, daunorubicin, and L-asparaginase represented majority of combination chemotherapy that resulted in alopecia (63.3%) at 3-6 weeks of treatment (48.3%). Most hair loss was found on pillow (65.9%). Â Conclusion Age, risk stratification, chemotherapy phase, and alopecia onset significantly correlated with chemotherapy agents. ÂReferences
Perdana AB, Saputra F, Aisyi M. Update on Diagnosis of Childhood Acute Lymphoblastic Leukemia (ALL) in Indonesia. Indones J Cancer. 2020;14(4):115–6.
Meirizkia A, Ayu DR, Indra RM, Sari DP. 3-year survival rate in acute lymphoblastic leukemia: comparison of ALL-2006 and ALL-2013 Protocols. Paediatr Indones. 2021;61(3):155–64.
Saraswat N, Chopra A, Sood A, Kamboj P, Kumar S. A Descriptive Study to Analyze Chemotherapy-Induced Hair Loss and its Psychosocial Impact in Adults: Our Experience from a Tertiary Care Hospital. Indian Dermatol Online J. 2019;10(4):426-30.
Haryono SJ, Sutandyo N, Karsono R, Karsono B, Purwanto DJ, Dien A, et al. Treatment Pattern and Safety Results of Docetaxel-(Taxotere®)-Based Chemotherapy in Early Breast Cancer Patients in Indonesia: Part of Asia-Pacific Breast Initiative II. Indones J Cancer. 2019;13(1):1–4.
Yun SJ, Kim SJ. Hair loss pattern due to chemotherapy-induced anagen effluvium: a cross-sectional observation. Dermatol Basel Switz. 2007;215(1):36–40.
Gunawan S, Broeke CT, Ven Pv, Arnoldussen M, Kaspers G, Mostert S. Parental Experiences with Chemotherapy-Induced Alopecia among Childhood Cancer Patients in Indonesia. Asian Pac J Cancer Prev. 2016;17(4):1717-23.
Choi EK, Kim IR, Chang O, Kang D, Nam SJ, Lee JE, et al. Impact of chemotherapy-induced alopecia distress on body image, psychosocial well-being, and depression in breast cancer patients. Psychooncology. 2014;23(10):1103–10.
Elisafitri R, Arsin AA, Wahyu A. Kesintasan pasien leukemia limfoblastik akut pada anak di rsup.dr.wahidin sudirohusodo makassar. J Kesehat Masy Marit [Internet]. 2018 [cited 2024 Jan 22];1(3). Available from: https://journal.unhas.ac.id/index.php/jkmmunhas/article/view/8819
Jastaniah W, Essa MF, Ballourah W, Abosoudah I, Al Daama S, Algiraigri AH, et al. Incidence trends of childhood acute lymphoblastic leukemia in Saudi Arabia: Increasing incidence or competing risks? Cancer Epidemiol. 2020;67:101764.
Kakaje A, Alhalabi MM, Ghareeb A, Karam B, Mansour B, Zahra B, et al. Rates and trends of childhood acute lymphoblastic leukaemia: an epidemiology study. Sci Rep. 2020;10(1):6756.
Yulianti E, Adnan N. Faktor-Faktor Prognostik Kesintasan 5 Tahun Leukemia Limfoblastik Akut Pada Anak Usia 1 - 18 Tahun. Promot J Kesehat Masy. 2020;10(2):86-96.
Adinatha Y, Ariawati K. Gambaran karakteristik kanker anak di RSUP Sanglah, Bali, Indonesia periode 2008-2017. Intisari Sains Medis. 2020;11(2):575–81.
Sitaresmi MN, Mostert S, Purwanto I, Gundy CM, Sutaryo null, Veerman AJP. Chemotherapy-related side effects in childhood acute lymphoblastic leukemia in Indonesia: parental perceptions. J Pediatr Oncol Nurs Off J Assoc Pediatr Oncol Nurses. 2009;26(4):198–207.
Risk Factors for Childhood Leukemia [Internet]. [cited 2024 Jan 22]. Available from: https://www.cancer.org/cancer/types/leukemia-in-children/causes-risks-prevention/risk-factors.html
Grávalos C, SanmartÃn O, Gúrpide A, España A, Majem M, Suh Oh HJ, et al. Clinical management of cutaneous adverse events in patients on targeted anticancer therapies and immunotherapies: a national consensus statement by the Spanish Academy of Dermatology and Venereology and the Spanish Society of Medical Oncology. Clin Transl Oncol Off Publ Fed Span Oncol Soc Natl Cancer Inst Mex. 2019;21(5):556–71.
Luanpitpong S, Rojanasakul Y, Luanpitpong S, Rojanasakul Y. Chemotherapy-Induced Alopecia. In: Topics in Cancer Survivorship [Internet]. IntechOpen; 2012 [cited 2024 Jan 22]. Available from: https://www.intechopen.com/chapters/26736
Menon A, Handattu S, Shetty J, Girisha B. Study of cutaneous adverse effects of cancer chemotherapy. Clin Dermatol Rev. 2018;2(1):19.
Pavey RA, Kambil SM, Bhat RM. Dermatological adverse reactions to cancer chemotherapy. Indian J Dermatol Venereol Leprol. 2015;81(4):434.
Vagace JM, Gervasini G, Vagace JM, Gervasini G. Chemotherapy Toxicity in Patients with Acute Leukemia. In: Acute Leukemia - The Scientist’s Perspective and Challenge [Internet]. IntechOpen; 2011 [cited 2024 Jan 22]. Available from: https://www.intechopen.com/chapters/25130
Botchkarev VA. Molecular mechanisms of chemotherapy-induced hair loss. J Investig Dermatol Symp Proc. 2003;8(1):72–5.
Honaker JS, Korman NJ. Cytotoxic and Antimetabolic Agents. In: Kang S, Amagai M, Bruckner AL, Enk AlH, Margolis DJ, McMichael AJ, et sl, editor. Fitzpatrick’s Dermatology. 9th edition. New York: Mc Graw Education; 2019. p. 3463–92.
Rossi A, Fortuna MC, Caro G, Pranteda G, Garelli V, Pompili U, et al. Chemotherapy-induced alopecia management: Clinical experience and practical advice. J Cosmet Dermatol. 2017;16(4):537–41.
Wikramanayake TC, Haberland NI, Akhundlu A, Laboy Nieves A, Miteva M. Prevention and Treatment of Chemotherapy-Induced Alopecia: What Is Available and What Is Coming? Curr Oncol Tor Ont. 2023;30(4):3609–26.
