Abstract
Chronic lymphocytic leukemia (CLL) is the most common blood malignancy with multiple therapeutic challenges. Cold physical plasma has been considered a promising approach in cancer therapy in recent years. In this study, we aimed to evaluate the cytotoxic effect of cold plasma or plasma-treated solutions (PTS) on hematologic parameters in the whole blood of CLL patients. The mean red blood cell count, white blood cell (WBC) count, platelet and hemoglobin counts, and peripheral blood smear images did not significantly differ between treated and untreated samples in either CLL or healthy individuals. However, both direct plasma and indirect PTS treatment increased lipid peroxidation and RNS deposition in the whole blood of CLL patients and in healthy subjects. In addition, the metabolic activity of WBCs was decreased with 120 s of cold plasma or PTS treatment after 24 h and 48 h. However, cold plasma and PTS treatment did not affect the prothrombin time, partial thromboplastin time, nor hemolysis in either CLL patients or in healthy individuals. The present study identifies the components of cold plasma to reach the blood without disturbing the basic parameters important in hematology, confirming the idea that the effect of cold plasma may not be limited to solid tumors and possibly extends to hematological disorders. Further cellular and molecular studies are needed to determine which cells in CLL patients are targeted by cold plasma or PTS.
Highlights
Chronic lymphocytic leukemia (CLL) is the most common hematologic malignancy worldwide [1,2], which is characterized by the accumulation of monoclonal CD5+ matureB cells in the bone marrow, peripheral blood, and lymphoid organs, such as lymph nodes, and spleen [2,3]
The CLL patients were diagnosed and selected by a hematology–oncology specialist based on white blood cell count, cell morphology, immunophenotyping analysis, clinical symptoms, and microscopic observations of peripheral blood smear according to the standards outlined by the WHO [31]
The selective nature of cold plasma is hypothesized to rely on ill-fated metabolism and baseline ROS/RNS in cancer cells compared to non-malignant counterparts, suggesting the former to be more sensitive to external ROS/RNS stressors and eventually leading to cell death [36,37]
Summary
Chronic lymphocytic leukemia (CLL) is the most common hematologic malignancy worldwide [1,2], which is characterized by the accumulation of monoclonal CD5+ mature. B cells in the bone marrow, peripheral blood, and lymphoid organs, such as lymph nodes, and spleen [2,3]. Increasing the number of mature B cells in the blood reduces the ability of the bone marrow to produce red blood cells (RBCs) and platelets (PT) in CLL patients [4]. There is a relationship between induction of oxidative stress and antileukemia chemotherapeutic agents [5,6,7]. Leukemic cells have increased basal oxidative stress, making them vulnerable to chemotherapeutic drugs that further elevate ROS levels [8,9,10]. The development of new avenues, such as gas plasma technology, may be promising for CLL treatment
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