Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-03-21T00:24:48Z No. of bitstreams: 1 CamilaDeCarvalhoGomes_DISSERT.pdf: 580845 bytes, checksum: c4711c562aa7338ecab71f7585d2841c (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-27T19:37:41Z (GMT) No. of bitstreams: 1 CamilaDeCarvalhoGomes_DISSERT.pdf: 580845 bytes, checksum: c4711c562aa7338ecab71f7585d2841c (MD5) / Made available in DSpace on 2017-03-27T19:37:41Z (GMT). No. of bitstreams: 1 CamilaDeCarvalhoGomes_DISSERT.pdf: 580845 bytes, checksum: c4711c562aa7338ecab71f7585d2841c (MD5) Previous issue date: 2016-11-10 / O c?ncer corresponde a um grupo de v?rias doen?as que t?m em comum a prolifera??o descontrolada de c?lulas anormais e que pode ocorrer em qualquer local do organismo. Os tumores mais frequentes na inf?ncia e na adolesc?ncia s?o as Leucemias, e a Leucemia Linfobl?stica Aguda (LLA) ? a mais prevalente. A desnutri??o evidenciada nesses pacientes est? relacionada ? s?ndrome da anorexiacaquexia desencadeada pela doen?a, mas tamb?m nas altera??es do apetite, que ocorrem durante o tratamento quimioter?pico e interferem no estado nutricional bem como na resposta a terapia antineopl?sica. Embora seja reconhecida a poss?vel influ?ncia dos horm?nios relacionados ao apetite sobre as altera??es no consumo alimentar de pacientes com LLA durante o tratamento quimioter?pico, poucos estudos na literatura investigaram as altera??es hormonais em pacientes com c?ncer infantojuvenil. Diante disso, o objetivo desse estudo foi avaliar o estado nutricional e os n?veis dos principais horm?nios relacionados ao apetite em crian?as e adolescentes portadoras de LLA na fase de indu??o do tratamento quimioter?pico. Para atingir o objetivo, foram acompanhadas 14 crian?as ou adolescentes com o diagn?stico de LLA durante os 28 dias do ciclo de indu??o do tratamento quimioter?pico. No momento basal (antes do in?cio da quimioterapia), na metade e ao final desse ciclo foram realizadas avalia??es de estado nutricional antropom?trico, do consumo alimentar e diet?tico sob a forma de registro alimentar pesado, e dos marcadores bioqu?micos e hormonais. Foram avaliados os seguintes horm?nios relacionados ao apetite: leptina, grelina, insulina e cortisol. A maioria dos pacientes apresentava eutrofia no in?cio do tratamento, e este diagn?stico n?o foi alterado de forma significativa durante o ciclo de indu??o. O consumo alimentar e diet?tico apresentou um aumento ao longo do ciclo, especialmente em rela??o ao consumo de prote?nas e lip?deos do in?cio at? o final do tratamento. Em rela??o aos par?metros bioqu?micos, observou-se aumento significativo nos par?metros das plaquetas e na transaminase glut?mica pir?vica, assim como redu??o significativa nas concentra??es de glicemia, creatinina e o s?dio. Sobre os horm?nios relacionados ao apetite, registrou-se altera??o estatisticamente significativa apenas na concentra??o de grelina, que apresentou um aumento entre os momentos basal e meio do ciclo (p=0,027), mas n?o do meio para o final do ciclo. Em conclus?o, o per?odo de indu??o do tratamento da LLA provocou um aumento no consumo de energia e nutrientes, assim como um aumento na concentra??o de grelina, mas sem repercuss?o sobre o estado antropom?trico dos pacientes ou nos outros horm?nios relacionados ao apetite. / Cancer is a group of several diseases that have in common an uncontrolled proliferation of abnormal cells, and it can occur at anywhere in the body. The most frequent tumors in childhood and adolescence are the leukemias, and the Acute Lymphoblastic Leukemia (ALL) is the most prevalent. The evidenced malnutrition in these patients is related to anorexia-cachexia syndrome triggered by the disease, but also on changes in appetite, which occur during chemotherapy and interfere in the nutritional status as well as in response to antineoplasic therapy. Although it recognized a possible influence of hormones related to appetite on the changes in food consumption of ALL patients during chemotherapy, few studies have investigated the hormonal changes in patients with childhood cancers. Thus, the aim of this study was to evaluate the nutritional status and levels of key hormones related to appetite in children and adolescents with Acute Lymphoblastic Leukemia (ALL) in the induction phase of chemotherapy. For this purpose, it was assessed 14 children/adolescents diagnosed with ALL during the 28 days of induction chemotherapy cycle. At baseline (prior to initiation of chemotherapy), in the middle and at the end of this cycle were performed anthropometric measurement, weighted food record 24 hours and biochemical and hormone levels were obtained. It were evaluated the following hormones related to appetite: leptin, ghrelin, insulin and cortisol. Most patients had normal weight at the beginning of treatment which did not change significantly during the induction cycle. The dietary intake increased over the cycle, particularly in relation to proteins and lipids intake from the beginning to the end of treatment. Platelet levels and transaminase glutamic pyruvic significantly increased, and a significant reduction in blood glucose, creatinine and sodium levels were observed. Regarding appetite hormones, ghrelin significantly increased between the baseline and the half of the cycle (p = 0.027), but not through the end. In conclusion, the ALL treatment induction period caused an increase in energy and nutrients intake, as well as an increase in the concentration of ghrelin, but no impact on the anthropometric status of patients or in other hormones related to appetite.