Meena Rachana, Nangia Anita, Sharma Sunita, Chandra Jagdish
Department of Pathology, Lady Hardinge Medical College, New Delhi, India.
Department of Paediatrics, Lady Hardinge Medical College, New Delhi, India.
Indian J Hematol Blood Transfus. 2021 Oct;37(4):586-592. doi: 10.1007/s12288-021-01413-0. Epub 2021 Feb 23.
Autocrine and paracrine loop involving vascular endothelial growth factor (VEGF) and its receptor have been described in haematological malignancies. However, scarce literature is present on angiogenesis in paediatric acute lymphoblastic leukemia (ALL) with studies showing controversial results. The aim was to study serum levels of VEGF and its receptors in paediatric ALL at the time of diagnosis and at the end of induction phase and to compare these levels with clinico-haematological parameters in these patients. Serum VEGF, VEGFR-1 and VEGFR-2 levels were measured by enzyme-linked immunoabsorbant assay at diagnosis (day 0) and at the end of induction phase (day 35) in 30 newly diagnosed paediatric ALL patients and in 10 healthy controls. Median s-VEGF was significantly lower at day 0 as compared to day 35 (196.15 vs. 606.75 pg/ml: < 0.001). s-VEGFR-1 levels were detectable only in 7 patients at day 0 and were below detection level at day 35 in all patients. Median s-VEGFR-2 at day 0 was significantly lower as compared to day 35 (17,577.5 vs. 20,507.5 pg/ml; = 0.005). Median VEGF-R1 showed an inverse relationship with VEGF-R2 but was statistically insignificant. All patients were in remission at the end of induction. Thus, leukemic infiltration of bone marrow affects angiogenesis and reduces pro-angiogenic markers VEGF and VEGFR-2 in serum possibly due to increased local consumption by blasts. A successful induction leads to clearing of blasts causing restoration of normal hematopoiesis with normalization of VEGF and VEGFR-2 levels.
血液系统恶性肿瘤中已描述了涉及血管内皮生长因子（VEGF）及其受体的自分泌和旁分泌循环。然而，关于小儿急性淋巴细胞白血病（ALL）血管生成的文献很少，研究结果存在争议。目的是研究小儿ALL诊断时和诱导期结束时血清VEGF及其受体水平，并将这些水平与这些患者的临床血液学参数进行比较。采用酶联免疫吸附测定法，对30例新诊断的小儿ALL患者和10例健康对照者在诊断时（第0天）和诱导期结束时（第35天）测定血清VEGF、VEGFR-1和VEGFR-2水平。与第35天相比，第0天的中位s-VEGF显著降低（196.15对606.75 pg/ml：<0.001）。s-VEGFR-1水平仅在第0天的7例患者中可检测到，所有患者在第35天均低于检测水平。与第35天相比，第0天的中位s-VEGFR-2显著降低（17,577.5对20,507.5 pg/ml；=0.005）。中位VEGF-R1与VEGF-R2呈负相关，但无统计学意义。所有患者在诱导期结束时均处于缓解状态。因此，骨髓的白血病浸润影响血管生成，并可能由于原始细胞局部消耗增加而降低血清中促血管生成标志物VEGF和VEGFR-2。成功的诱导导致原始细胞清除，使正常造血恢复，VEGF和VEGFR-2水平恢复正常。
