The Effect of Chemotherapy on Serum Carnitine Levels and Fatigue in Chemotherapy Naive Medical Oncology Patients: A Pilot Study. Carnitine, Chemotherapy and Fatigue

Wolfgang M Marx Laisateleni

doi:10.4172/2161-0509.1000131

Abstract

Abstract Background: Fatigue, a highly prevalent side-effect of anticancer therapy, poses a significant burden on patient quality of life. Carnitine deficiency has been implicated in the development of fatigue during chemotherapy. Methods: This pilot study aimed to evaluate the relationship between chemotherapy-related fatigue and serum carnitine (total, free- and acyl: free carnitine ratio) in 35 chemotherapy-naive oncology patients at baseline, 6 and12 weeks. Results: Carnitine deficiency, based on acyl: free carnitine ratio, was detected in three patients at baseline but this did not persist to the next time point. Carnitine deficiency was not detected in any other participant throughout this study and levels of carnitine were not correlated with fatigue during the study period. Conclusion: A relationship between carnitine status and fatigue was not found at the time points measured. Further research is required to confirm these results in a larger medical oncology population.

Highlights

Fatigue is the most common side-effect reported by oncology patients undergoing cytotoxic treatment [1]
While not all studies found that chemotherapy resulted in carnitine deficiency, all studies found carnitine metabolism to be significantly impaired during the study period
Most studies to date have only measured the acute changes in carnitine status during chemotherapy rather than over the course of multiple cycles which is typical of most chemotherapy regimens

Summary

Introduction

Fatigue is the most common side-effect reported by oncology patients undergoing cytotoxic treatment [1]. Multiple studies have evaluated carnitine status in oncology patients undergoing chemotherapy using serum and/or urinary markers of carnitine [4,5,6,7,8,9,10,11]. Chemotherapy regimens including doxorubicin, Platinum-based therapies (e.g. cisplatin), and ifosfamide have been shown to disrupt regular carnitine metabolism. Several potential mechanisms have been proposed including an increased rate of renal excretion [5,8] a reduction in cellular uptake [12] and an increase in the metabolic demand for carnitine [13] prolonged exposure to these regimens may result in carnitine deficiencies [7]. Carnitine deficiency has been implicated in the development of fatigue during chemotherapy

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Results

Discussion

Conclusion