КЛИНИКО-ДИАГНОСТИЧЕСКОЕ ЗНАЧЕНИЕ ЦИТОКИНОВОГО ПРОФИЛЯ В ПЛАЗМЕ КРОВИ И ЛИКВОРЕ У ДЕТЕЙ С ОСТРЫМ ЛИМФОБЛАСТНЫМ ЛЕЙКОЗОМ ПРИ ФОРМИРОВАНИИ ВИНКРИСТИН-ИНДУЦИРОВАННОЙ ПЕРИФЕРИЧЕСКОЙ ПОЛИНЕВРОПАТИИ

Abstract

Vincristine-induced peripheral neuropath (VIPN) is the main neurotoxic complication in the treatment of acute lymphoblastic leukemia (ALL) in children. The mechanisms for peripheral nerve system injury are not fully understood, rand recent studies have shown the involvement of the immune system. Objective of the study: to determine the cytokine profiles in blood plasma and cerebrospinal fluid in children with ALL and determine their relationship with the formation of VIPN. Materials and methods of research: 65 patients aged 3–17 years with ALL participated in a single-center prospective observational cohort study who underwent chemotherapy treatment according to the ALL-MB-2015 protocol. The patients were divided into two groups based on the severity of VIPN: the 1st group (n=44) – patients with ALL, having neurological manifestations of VIPN, and the 2nd group (n=21) – children with ALL without clinical symptoms of peripheral neuropathy. Levels of cytokines were observed in children’s blood plasma and cerebrospinal fluid by the multiparametric immunofluorescence assay. Results: Comparison of cytokines levels in blood plasma and cerebrospinal fluid represented an increase in CXCL10 (IP-10), CXCL12 (SDF-1α) and stem cells factor (SCF) in the group of children with clinical signs of VIPN. Results suggested statistically significant twofold increase in CXCL10 (IP-10) in blood plasma (p<0,001), an increase in CXCL12 (SDF-1α) in blood plasma and cerebrospinal fluid (p<0.01 and p=0.05, respectively) and SCF in the cerebrospinal fluid (p=0.03). In addition, it was established that a mixed detection of the levels of CXCL10 (IP-10) and CXCL12 (SDF-1α) in blood plasma is highly informative. Conclusion: the results obtained allow us to consider the indications of CXCL10 (IP-10), CXCL12 (SDF-1α) and SCF as biological markers for early diagnosis of VIPN.