Key result
Omega 3 fatty acids preserved systolic function and prevented significant increases in troponin I, CK-MB, and NT-proBNP compared to control in children with ALL receiving doxorubicin.
Why the study?
Omega 3 polyunsaturated fatty acids have beneficial cardiovascular effects, but their potential protective effect against early doxorubicin-induced cardiotoxicity in children with acute lymphoblastic leukemia required evaluation.
Do omega 3 fatty acids prevent early doxorubicin-induced cardiotoxicity in children with acute lymphoblastic leukemia?
RCT (n=60)
randomized
Do omega 3 fatty acids prevent early doxorubicin-induced cardiotoxicity in children with acute lymphoblastic leukemia?
Omega 3 fatty acid supplementation may protect against early doxorubicin-induced cardiotoxicity and preserve left ventricular systolic function in children with acute lymphoblastic leukemia.
Answers are grounded in this paper and cite their sources.
May support omega-3 use for doxorubicin cardioprotection in pediatric ALL; hypothesis-generating and requires randomized confirmation before practice change.
OBJECTIVES: Omega 3 polyunsaturated fatty acids are dietary factors with several beneficial cardiovascular effects. This study aimed to assess the possible protective effect of omega 3 fatty acids on early doxorubicin-induced cardiac toxicity in children with acute lymphoblastic leukemia (ALL). PATIENTS AND METHODS: Sixty children of newly diagnosed ALL were randomized into two groups: group I (n = 30) who received omega 3 fatty acids 1000 mg/day for 6 months in addition to their usual protocol of chemotherapy including doxorubicin; and group II (n = 30) who received their usual doxorubicin protocol during the period from February 2020 till August 2021. Echocardiographic examinations were performed before and after the treatment. Glutathione, malondialdehyde (MDA), superoxide dismutase (SOD), troponin I, creatine kinase MB (CK-MB), and N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured also before and after omega 3 treatment. RESULTS: After 6 months of omega 3 administration, group I had a significantly lower MDA level and a significantly higher glutathione and SOD levels than group II. Similarly, the levels of troponin I, CK-MB, and NT-proBNP were significantly high in group II, whereas they were unchanged in group I after treatment. Similarly, systolic function (presented with peak mitral annular systolic velocity and two-dimensional global longitudinal strain) of the heart was preserved in omega 3-treated patients, unlike the control group that showed significant impairment of left ventricular function after 6 months. CONCLUSION: Omega 3 fatty acids may decrease early cardiac injury and doxorubicin-induced cardiotoxicity in children with ALL.
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Amrousy et al. (2021) conducted an RCT in acute lymphoblastic leukemia (ALL) (n=60). Omega 3 fatty acids vs. Usual doxorubicin protocol was evaluated on Early doxorubicin-induced cardiac toxicity (echocardiographic parameters and cardiac biomarkers). Omega 3 fatty acids preserved systolic function and prevented significant increases in troponin I, CK-MB, and NT-proBNP compared to control in children with ALL receiving doxorubicin.
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