Department of Internal Medicine, Hypertension and Clinical Oncology, Faculty of Medicine, Wroclaw Medical University, 213 Borowska St., Wroclaw, 50-556, Poland.
Department of Pediatric Oncology, Hematology and Bone Marrow Transplantation, Wroclaw Medical University, 213 Borowska St., Wroclaw, 50-556, Poland.
Biomed Res Int. 2018 Nov 11;2018:7918091. doi: 10.1155/2018/7918091. eCollection 2018.
Endothelial dysfunction is a common feature of early complications of hemato-oncologic therapy. The aim of our study was to assess the profile of endothelial function at diagnosis time, then during initial treatment phase of acute lymphoblastic leukemia (ALL), and to verify the presence of its correlation with early clinical outcome (ECO). 28 ALL children and 18 healthy age-matched control ones were recruited. Study group was examined at baseline and at 33rd and 78th day of treatment. At each protocol step the endothelial function was assessed by measurement of sP-selectin (CD62-P), PAI-1(serpinE1), sE-selectin (CD62E), sICAM-1(sCD54), sVCAM-1(sCD106), and VEGF concentrations. Higher baseline sICAM-1 and sVCAM-1 levels and lower sP-selectin and VEGF were observed in children with ALL. sICAM-1, sVCAM-1, and sE-selectin levels were decreasing following the treatment with protocol I. Higher sE-selectin and lower baseline sICAM-1 levels were observed in children treated unsuccessfully. Lower PAI-1 levels were observed in children who survived. Higher baseline sE-selectin levels and lower sICAM-1 and VEGF were observed in children treated unsuccessfully. A decrease in sE-selectin and lower PAI-1 at the 78th day of therapy were associated with better ECO. High baseline VEGF and sE-selectin levels, significant increase in PAI-1, and low initial sICAM-1 levels are prognostics for poorer prognosis in the ALL children.
内皮功能障碍是血液肿瘤治疗早期并发症的共同特征。我们的研究目的是评估诊断时的内皮功能谱，然后在急性淋巴细胞白血病（ALL）的初始治疗阶段，并验证其与早期临床结果（ECO）的相关性。招募了 28 名 ALL 儿童和 18 名年龄匹配的健康对照组。研究组在基线和治疗第 33 天和第 78 天进行检查。在每个方案步骤中，通过测量 sP-选择素（CD62-P）、PAI-1（丝氨酸蛋白酶抑制剂 E1）、sE-选择素（CD62E）、sICAM-1（sCD54）、sVCAM-1（sCD106）和 VEGF 浓度来评估内皮功能。与 ALL 儿童相比，基线时 sICAM-1 和 sVCAM-1 水平较高，sP-选择素和 VEGF 水平较低。随着方案 I 的治疗，sICAM-1、sVCAM-1 和 sE-选择素水平降低。在治疗不成功的儿童中观察到更高的 sE-选择素和较低的基线 sICAM-1 水平。存活的儿童观察到较低的 PAI-1 水平。在治疗不成功的儿童中观察到较高的基线 sE-选择素水平以及较低的 sICAM-1 和 VEGF。治疗第 78 天 sE-选择素下降和 PAI-1 降低与更好的 ECO 相关。高基线 VEGF 和 sE-选择素水平、PAI-1 显著增加以及初始 sICAM-1 水平较低是 ALL 儿童预后较差的预后因素。
