CHARACTERISTICS CHANGES IN PRO-OXIDANT-ANTIOXIDANT STATUS IN PATIENTS WITH ACUTE LEUKEMIA DURING CHEMOTHERAPY

Abstract

Changes in the processes of lipid peroxidation and antioxidant system activity are involved in the pathogenesis of carcinogenesis and can affect tumor resistance to chemotherapy. The aim of this study to investigate the nature of changes in pro-oxidant-antioxidant status in patients with acute leukemia during remission induction chemotherapy. Materials and methods. The study involved 42 patients with newly diagnosed acute leukemia, 22 of them were diagnosed to have acute myeloid leukemia and 20 patients had acute lymphoblastic leukemia. The age range was 18-58 years, there were 19 women (45.2%) and 23 men (54.8%). The patients were divided into two groups: I (n=22) included patients with acute myeloid leukemia, who had chemotherapy modes "7+3" and "5+2" for variants M0-2 and "7+3+etoposide" or "5+2+etoposide" for M4-5 variants; II (n=20) group included patients with acute lymphoblastic leukemia, who received chemotherapy according to D. Hoelzer protocol. Hemogram parameters (red blood cells, hemoglobin, white blood cells, platelets) were evaluated at baseline and on the 28th day of chemotherapy. The concentration of thiobarbituric acid reactive substances and catalase activity in the blood serum were assessed as well. Examination of acute myeloid leukemia patients was performed before the chemotherapy, on the 4th and 28th days since chemotherapy started; acute lymphoblastic leukemia patients were examined before chemotherapy, on the 23rd and 28th days. The group of healthy individuals consisted of 20 persons, including 9 (45%) women and 11 (55%) men, aged 22-26 years. Results. The detailed clinical picture of acute leukemia was accompanied by typical changes in hemogram in the patients of both test groups, and namely, by the development of leukocytosis, anemia, thrombocytopenia. At the same time, the patients with acute myeloid leukemia and acute lymphoblastic leukemia demonstrated an increased concentration of thiobarbituric acid reactive substances in 1.8 and 1.89 times, respectively (p<0.05) that was accompanied by an increased serum catalase activity in 1.96 and 1.8 times, respectively (p<0.05) compared to healthy individuals. During "7+3" chemotherapy, acute myeloid leukemia patients were found to show thiobarbituric acid reactive substances increased in 1.9 times on the 4th day of treatment and decreased on the 28th day.The patients with acute lymphoblastic leukemia managed according to the D. Hoelzer protocol demonstrated an increased concentration of thiobarbituric acid reactive substances in the blood serum in 1.33 times on the 23rd day of treatment (p<0.05), maintaining this level up to the 28th day. The catalase activity in the patients of the comparison groups did not change. Conclusion. The debut of acute leukemia is accompanied by activation of lipid peroxidation and antioxidant system enzymes. Сhemotherapy promotes the shift of the prooxidant-antioxidant equilibrium towards the lipid peroxidation activation.