Contributions
Abstract: PB1366
Type: Publication Only
Session title: Acute lymphoblastic leukemia - Clinical
Background
There are few data on metabolic changes in the body of children who have suffered from ALL and have a long-term EFS. The relationship between thyroid status, protein and iron metabolism has not been described under such conditions so far. The contact of described patients group with radiation factor has not been taken into account also.
Aims
To determine the influnce of ferritin on thyroid function and connection with amino acids (AC) profile in the urine of patients affected by the Chornobyl accident and who suffered from ALL in childhood.
Methods
There are 84 children living in radiation-contaminated areas and suffered from ALL in childhood (pro B - 8, common ALL - 66, pre-B - 6, T-ALL - 4) were examined. EFS of the patients ranged from 10 to 15 years. Ionising radiation dose for bone marrow of children were 5.31 ± 1.14 mSv. All children were examined after completing the full course of chemotherapy for ALL. The percentage and morphological characteristics of bone marrow erythroid cells, erythrocytes morphometric parameters, serum iron, serum ferritin (SF) and transferrin levels, transferrin saturation coefficient, the percentage of bone marrow sideroblasts, urine AC levels: Lyz, Arg, O-Pro (oxyproline), Asp, Tre, Ser, Glu, Pro, Gly, Ala, Cys,Val, Met, Leu, Tyr, Phe; serum thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels were stydied. We used generally accepted statistical methods (t-Student, Spearman's correlation coefficient, U-Test).
Results
In 53 children (63.1%) - SF was 285.4 ± 11.3 ng / ml, in 16 (19%) - 497.6 ± 13.6 ng / ml, in 15 (17.9%) - 783.7 ± 14.2 ng / ml. After 3-5 years of treatment end in 14 children (16.6%) thyroid pathology was detected: in 6 - hypothyroidism (SF 423.5 ± 12.1 ng / ml), in 7 - thyroiditis (SF 851.2 ± 15.5 ng / ml), one child had papillary thyroid cancer (SF - 489.6 ng / ml). A positive correlation between TSH and O-Pro (rs = 0.42) and negative correlation with FT4 (rs = -0.52) was found. In addition, SF was inversely correlated with TSH (rs = -0.46). In patients with serum iron levels higher than 27 μmol / l, the correlation was established between its amount and O-Pro (rs = -0.88) and the precursor O-Pro - Proline (rs = 0.86), which are markers of the collagen condition. The obtained results emphasize metabolic changes in ALL patients with excess iron in the body, which adversely affect the thyroid function in the remote period after chemotherapy.
Conclusion
Ferrokinetic processes affect the mechanisms of leukemogenesis and metabolic changes in children, which is associated with the development of multiorgan pathology and requires correction at the proper time.
Keyword(s): Children, Iron metabolism, Leukemia, Long-term follow-up
Abstract: PB1366
Type: Publication Only
Session title: Acute lymphoblastic leukemia - Clinical
Background
There are few data on metabolic changes in the body of children who have suffered from ALL and have a long-term EFS. The relationship between thyroid status, protein and iron metabolism has not been described under such conditions so far. The contact of described patients group with radiation factor has not been taken into account also.
Aims
To determine the influnce of ferritin on thyroid function and connection with amino acids (AC) profile in the urine of patients affected by the Chornobyl accident and who suffered from ALL in childhood.
Methods
There are 84 children living in radiation-contaminated areas and suffered from ALL in childhood (pro B - 8, common ALL - 66, pre-B - 6, T-ALL - 4) were examined. EFS of the patients ranged from 10 to 15 years. Ionising radiation dose for bone marrow of children were 5.31 ± 1.14 mSv. All children were examined after completing the full course of chemotherapy for ALL. The percentage and morphological characteristics of bone marrow erythroid cells, erythrocytes morphometric parameters, serum iron, serum ferritin (SF) and transferrin levels, transferrin saturation coefficient, the percentage of bone marrow sideroblasts, urine AC levels: Lyz, Arg, O-Pro (oxyproline), Asp, Tre, Ser, Glu, Pro, Gly, Ala, Cys,Val, Met, Leu, Tyr, Phe; serum thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels were stydied. We used generally accepted statistical methods (t-Student, Spearman's correlation coefficient, U-Test).
Results
In 53 children (63.1%) - SF was 285.4 ± 11.3 ng / ml, in 16 (19%) - 497.6 ± 13.6 ng / ml, in 15 (17.9%) - 783.7 ± 14.2 ng / ml. After 3-5 years of treatment end in 14 children (16.6%) thyroid pathology was detected: in 6 - hypothyroidism (SF 423.5 ± 12.1 ng / ml), in 7 - thyroiditis (SF 851.2 ± 15.5 ng / ml), one child had papillary thyroid cancer (SF - 489.6 ng / ml). A positive correlation between TSH and O-Pro (rs = 0.42) and negative correlation with FT4 (rs = -0.52) was found. In addition, SF was inversely correlated with TSH (rs = -0.46). In patients with serum iron levels higher than 27 μmol / l, the correlation was established between its amount and O-Pro (rs = -0.88) and the precursor O-Pro - Proline (rs = 0.86), which are markers of the collagen condition. The obtained results emphasize metabolic changes in ALL patients with excess iron in the body, which adversely affect the thyroid function in the remote period after chemotherapy.
Conclusion
Ferrokinetic processes affect the mechanisms of leukemogenesis and metabolic changes in children, which is associated with the development of multiorgan pathology and requires correction at the proper time.
Keyword(s): Children, Iron metabolism, Leukemia, Long-term follow-up