Summary:

  Fatigue  is  the  most frequent  symptom experienced by children/adolescents with cancer. One mechanism contributing to cancer-related fatigue involves abnormalities in adenosine tri- phosphate synthesis caused by carnitine deficiency. The purpose of this study was to examine fatigue and carnitine in children,i adolescents before and after ifosfamide, cisplatin, or doxorubicin chemotherapy. Sixty-seven patients from 2 children's cancer centers participated. Fatigue and carnitine measures were obtained before chemotherapy and a week later. Newly diagnosed children,iado- lescents had significantly higher free (P一0.018) and total carnitine levels (P一0.017) compared with those who received prior chemo-therapy. There was a significant increase in free and total carnitine levels  after  treatment  for  patients  receiving  doxorubicin  than

patients receiving cisplatin or ifosfamide. Increased fatigue and decreased  carnitine  were  significantly  correlated  a  week  after chemotherapy  in  children,iadolescents  who  had  received  prior chemotherapy. Increased carnitine in newly diagnosed patients is likely associated with rapid tissue release into the bloodstream,replacing carnitine lost by chemotherapy metabolism. Decreased carnitine and increased fatigue occurred after 1 to 2 courses of chemotherapy.  This  study provides  support for a relationship between carnitine and fatigue in children/adolescents with cancer.

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