Нутритивная поддержка ребенка с ювенильным миеломоноцитарным лейкозом на различных этапах противоопухолевого лечения: клинический случай

М. С. Шамсутдинова, Ю. А. Алымова, А. Ю. Вашура
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Abstract

Background . Juvenile myelomonocytic leukaemia is a malignant disease with clonal impairment of haematopoiesis, characterized by excessive proliferation of monocytic and granulocytic sprout. Currently, the only way to cure it is hematopoietic stem cell transplantation. Vigorous treatment is accompanied by the development of a large number of complications, including nutritional ones. Nutritional support for these patients is fraught with many difficulties due to the treatment characteristics, patient’s condition, and complications of therapy. Description of a Clinical Case . A child diagnosed with juvenile myelomonocytic leukaemia, 1 year and 11 months old, received antineoplastic therapy — chemotherapy and bone marrow transplantation. In the course of treatment and after it, severe complications developed, which required various types of nutritional support, depending on the clinical situation. It is illustrated how important timely nutritional support is and how long and difficult nutritional disorders can proceed in these children even after termination of the main therapy. Conclusion . Preventive nutritional support with infant formulas is advisable for children with oncological diseases prior to treatment even with normal nutritional indicators. With the potential long-term impossibility of adequate alimentation per os, it is advisable to consider the placement of a gastrostomy tube for enteral nutrition since problems with appetite can be very long.
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在抗肿瘤治疗的不同阶段,对患有粒细胞单细胞白血病的儿童的核心支持:临床病例
背景。青少年髓单细胞白血病是一种以克隆性造血功能障碍为特征的恶性疾病,其特点是单核细胞和粒细胞芽细胞过度增生。目前,唯一的治疗方法是造血干细胞移植。积极的治疗伴随着大量并发症的出现,包括营养问题。由于治疗特点、患者自身状况、治疗并发症等因素,对该类患者的营养支持存在诸多困难。临床病例描述。一名1岁零11个月的儿童被诊断为少年髓细胞白血病,接受了抗肿瘤治疗-化疗和骨髓移植。治疗过程中及治疗后出现严重并发症,需要根据临床情况给予各种营养支持。这说明了及时的营养支持是多么重要,即使在主要治疗结束后,这些儿童的营养失调仍会持续多长时间和多困难。结论。对于患有肿瘤疾病的儿童,即使营养指标正常,在治疗前也建议使用婴儿配方奶粉进行预防性营养支持。由于可能长期无法获得足够的营养,考虑放置胃造口管进行肠内营养是可取的,因为食欲问题可能会持续很长时间。
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