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Plasma citrulline as a biomarker for enterocyte integrity in pediatric blood and BMT

Bone Marrow Transplantation volume 49, pages 449–450 (2014)Cite this article

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Myeloablative regimens are the backbone of hematopoietic SCT (HSCT) and are associated with prolonged periods of gastrointestinal morbidities and compromised gut integrity. While not yet validated for the pediatric or adult HSCT population, serum citrulline levels appear to be an appropriate and accurate measure of morbidities following myeloablative therapy.1, 2, 3, 4, 5 Chemotherapy induces a decrease in citrulline levels,1, 2, 6 and citrulline has also been found to correlate with the radiation dose received and volume of bowel in the field of radiation.1, 7, 8 In a pilot study of nine pediatric patients with AML undergoing chemotherapy, citrulline showed the strongest correlation with clinical mucositis scales.9

This study aimed to determine whether citrulline levels correlate with clinical markers of intestinal injury in children undergoing a myeloablative allogeneic transplant regimen. Secondary aims included collecting reference values for this population, investigation of associations between the prevalence of infections and acute GVHD and citrulline, and the effect of TBI on citrulline levels.

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Acknowledgements

This research was supported by the Tamarind Foundation. We would like to thank David Mack, MD, for his consultation and advisement on this project. Joelle Karlik, MD, was supported by the Doris Duke Clinical Research Foundation as a Doris Duke Clinical Research Fellow of Columbia University.

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Authors and Affiliations

  1. Division of Pediatric Hematology/Oncology/Stem Cell Transplantation, Center for Comprehensive Wellness, Columbia University Medical Center, New York, NY, USA

    J B Karlik, R Hawks, M Bhatia & E J Ladas

  2. Pediatric Residency Program, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    J B Karlik

  3. Division of Pediatric Gastroenterology and Nutrition Rush University Medical Center, Chicago, IL, USA

    A Kesavan

  4. Department of Blood and Marrow Transplantation, All Children’s Hospital & Moffitt Cancer Center, Tampa, FL, USA

    M L Nieder

  5. Department of Biostatistics, Columbia University Medical Center, Mailman School of Public Health, New York, NY, USA

    Z Jin

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  1. J B Karlik
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  2. A Kesavan
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  3. M L Nieder
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Correspondence to E J Ladas.

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Karlik, J., Kesavan, A., Nieder, M. et al. Plasma citrulline as a biomarker for enterocyte integrity in pediatric blood and BMT. Bone Marrow Transplant 49, 449–450 (2014). https://doi.org/10.1038/bmt.2013.165

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