孟加拉国一家三级医院诱导化疗引起的急性淋巴细胞白血病患儿脂质谱变化

R. Siddique, Zamil Ahmed Manik, Azm Rayhanur Rahman, S. Santa, M. Hasan, C. Jamal
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引用次数: 0

摘要

背景:急性淋巴细胞白血病(Acute lymphoblastic leukemia, ALL)是儿童最常见的恶性肿瘤。在Bangabandhu Sheikh Mujib医科大学(BSMMU)的儿科血液学和肿瘤学部门,在一年内455名新诊断的恶性肿瘤患者中记录了58%的ALL病例。研究发现l -天冬酰胺酶治疗和类固醇治疗可发生显著的高甘油三酯血症。本研究旨在评价ALL患儿诱导化疗期间及化疗后血清总胆固醇、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)的变化。方法:这项前瞻性观察性研究于2013年3月- 11月在BSMMU儿科血液与肿瘤学系进行。新诊断的3-15岁急性淋巴细胞白血病患者在获得参与者父母的书面同意后被纳入本研究,并被纳入ALL治疗(根据修订的UKALL 2003方案)。结果:诱导治疗后总胆固醇、TG、HDL、LDL发生显著变化。l -天冬酰胺酶完成后血清总胆固醇和LDL较诱导前降低,诱导完成后较l -天冬酰胺酶完成后显著升高(P=0.001),诱导后较诱导治疗前显著升高(P=0.003)。l -天冬酰胺酶完成后TG较诱导前显著降低(P=0.033),诱导完成后TG升高。l -天冬酰胺酶完成后和诱导后HDL显著升高(P=0.001)。L天冬酰胺酶完成后LDL降低,差异有统计学意义(P=0.005)。结论:ALL患者诱导化疗后总胆固醇、HDL、LDL水平升高,TG水平降低。Bangabandhu Sheikh Mujib医科大学学报,2023;16(1):35-40
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Change of lipid profile in children with acute lymphoblastic leukemia due to induction chemotherapy in a tertiary care hospital of Bangladesh
Background: Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy. In the Department of Paediatric Haematology and Oncology of Bangabandhu Sheikh Mujib Medical University (BSMMU), 58% of ALL cases were recorded among 455 newly diagnosed malignancy patients in a single year. Studies found that remarkable hypertriglyceridemia occurs with L-asparaginase therapy and steroid. This study was done to evaluate the changes of serum total cholesterol, triglycerides (TG), high density lipoprotein (HDL), and low-density lipoprotein (LDL) during and after induction chemotherapy in children with ALL. Methods: This prospective observational study was performed in the Department of Pediatric Hematology and Oncology of BSMMU from March-November 2013. Newly diagnosed acute lymphoblastic leukemia patients aged 3-15 years were included in this study after having written consent from the parents of the participants to participate in the study and enrolled for the treatment of ALL (according to modified UKALL 2003 protocol). Results: Total cholesterol, TG, HDL, and LDL changed significantly due to induction therapy. Serum total cholesterol and LDL decreased after completion of L-asparaginse in comparison to before induction, increased significantly after completion of induction in comparison to after completion of L-asparaginase (P=0.001), and increased significantly after induction in relation to before induction therapy (P=0.003). TG decreased significantly (P=0.033) after completion of L-asparaginase than before induction but increased after completion of induction. HDL increased after completion of L-asparaginase and after induction significantly (P=0.001). LDL decreased after completion of L asparaginase which was significant (P=0.005). Conclusion: After induction chemotherapy, total cholesterol, HDL and LDL level increased and TG level decreased among ALL patients. Bangabandhu Sheikh Mujib Medical University Journal 2023;16(1): 35-40  
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