The Effect of Ursodeoxycholic acid and N-acetyl cysteine on Lymphoblast Viability

Aim: To investigate invitro ursodeoxycholic acid (UDCA) and N-acetyl cysteine (NAC) effect on blast cell viability in children newly diagnosed with acute lymphoblastic leukemia (ALL). Patients and Methods: Samples were obtained from 52 newly diagnosed ALL patients aged 1 to 17 years. UDCA and NAC were added at clinically relevant concentrations (0-300 micrograms) onto 5x10^5 cells treated at room temperature in a dark place. Untreated and treated cells were stained with 7-amino-actinomycin D (7AAD PE) and analyzed by flow cytometry Results: Median (interquartile range; IQR) blast percentage and incubation time were 90% (11) and 18 (1.5) hours, respectively. The dead/live blast cells ratio (7AAD+) was lower in lymphoblasts treated with all NAC concentrations than untreated controls (P < 0.001). The use of NAC was noted to, regardless of concentration, contribute to lymphoblasts viability. On the contrary, the dead/live blast cells ratio in samples treated with UDCA at the abovementioned concentrations was relatively high, suggesting the protective role for both hepatotoxicities and against leukemia. However, the difference was not statistically significant (P >0.05). There was also no correlation between different doses of UCDA and NAC regarding blast cell viability (P > 0.232). Conclusion: The present study showed that in vitro NAC use had a protective effect on lymphoblast viability in newly diagnosed ALL patients before starting chemotherapy. Patient-derived ALL cells can be successfully analyzed ex vivo in a short and different period without loss of blasts.