Association between thiamine decrease and neuropsychiatric symptoms in gastrointestinal and hematological cancer patients receiving chemotherapy - 03/09/21
, Tomohiro Kurokawa b, Shohei Andoh c, Yoshiaki Kanemoto b, Toyotaka Kawamata c, Kentaro Yazawa b, Aki Sato c, Kazuaki Yokoyama c, Yoichi Imai c, Giichiro Tsurita b, Yuka Ahiko b, d, Susumu Aikou b, d, Dai Shida b, d, Masanori Nojima e, Arinobu Tojo c, Munetoshi Sugiura f, Seiichiro Kuroda aBienvenue sur EM-consulte, la référence des professionnels de santé.
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Abstract |
Background |
Clinical evidence of thiamine-related neuropsychiatric symptoms, including the initial stage, is limited because serum thiamine levels tend to be evaluated only for patients who develop severe neuropsychiatric symptoms suspected to be related to severe thiamine deficiency. This study aimed to evaluate the relationship between thiamine decline and neuropsychiatric symptoms, including initial symptoms, and the effect of chemotherapy on serum thiamine levels in gastrointestinal and hematological cancer patients receiving chemotherapy.
Method |
We retrospectively identified 87 patients who were diagnosed with gastrointestinal and hematological cancers at our hospital. We evaluated the risk factors associated with neuropsychiatric symptoms, including initial symptoms (neuropsychiatric symptoms), the relationship between the presence of neuropsychiatric symptoms and serum thiamine levels, and changes in serum thiamine levels after chemotherapy.
Results |
Logistic regression analysis identified thiamine decline as a significant factor associated with neuropsychiatric symptoms (p < 0.001, odds ratio = 0.040, 95% confidence interval [CI]: 0.010–0.163). The Mann-Whitney U test showed that patients with neuropsychiatric symptoms had significantly lower serum thiamine levels (19.5 ± 5.4 ng/mL, n = 39) than patients without neuropsychiatric symptoms (31.9 ± 14.2 ng/mL, n = 48) (p = 0.001). In hematological cancer patients, serum thiamine levels gradually declined after chemotherapy, with the lowest levels at 5–8 weeks (23.5 ± 7.6 ng/mL, P = 0.035 vs. 0 weeks, Wilcoxon rank sum test).
Conclusion |
Our study showed that a decrease in serum thiamine levels can be a risk factor for neuropsychiatric symptoms, and chemotherapy can lead to a decrease in serum thiamine levels.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Thiamine decline was associated with neuropsychiatric symptoms. |
• | Chemotherapy can lower serum thiamine levels in cancer patients. |
• | Low dose thiamine may improve thiamine related neuropsychiatric symptoms. |
Abbreviations : ECOG, TD, ThDP, WE
Keywords : Thiamine, Neuropsychiatric symptoms, Gastrointestinal, Hematological, Cancer, Chemotherapy
Plan
Vol 141
Article 111929- septembre 2021 Retour au numéro
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