Plasma homocysteine as an indicator of folate and vitamin B[12] status in children with acute lymphoblastic leukemia

Folate and vitamin B[12] are important in ensuring proper DNA replication and normal cell division. Their depletion might enhance carcinogenesis. The sulphur containing amino acid homocysteine gained considerable interest as a useful marker of impaired function of folate and vitamin B[12]. The present work aimed to evaluate plasma homocysteine level as a more sensitive indicator of folate and vitamin B[12] status in children with acute lymphoblastic leukemia. This study included fifteen children with newly diagnosed acute lymphoblastic leukemia attending pediatric department of Shatby Hospital, Alexandria University. The control group included fifteen normal healthy volunteers matched for age and sex. In patients, blood samples were collected at the time of diagnosis before any treatment. RBC's folate, plasma folate and vitamin B[12] were estimated using RIA kit. Plasma homocysteine was determined using EIA kit. RBC's folate, plasma folate and vitamin B[12] were significantly lower while plasma homocysteine was significantly elevated in the patient group when compared to the control group. Plasma homocysteine correlated negatively with RBC's folate in both studied groups. This study showed a strong association between folate deficiency, hyperhomocysteinemia and ALL in children. Prospective studies are necessary to further define whether alterations in plasma tHcy and RBC's folate levels can be considered as risk markers or are a consequence of progression of acute lymphoblastic leukemia

Evaluation of tumor necrosis factor alpha [TNF-alpha], soluble P-selectin [sP-selectin], gammaglutamyl transferase [GGT], Glutathione S-tranferase Pi [GST-Pi] and alphafetoprotein [AFP] in patients with hepatocellular carcinoma before and during chemotherapy

Hepatocellular carcinoma [HCC] is an environmentally related cancer, with both viral and chemical carcinogens involved in multistage process. Up now, it is difficult to detect the asymptomatic precursor lesions in early stages of HCC. Therefore, the majority of HCC patients are not amenable to curative therapy as they are detected at late stages. To evaluate the significance of TNFa, sP-selectin, GOT, GST-Pi and AFP in the diagnosis and follow up of HCC patients during chemotherapy with adriamycin, 45 subjects were studied [15 healthy volunteers as control group, 15 with benign liver diseases [SHF], and 15 HCC patients before and during chemotherapy [3 cycles of intravenous adriamycin]. HCC patients had significantly higher serum level of TNF alpha, sP-selectin, GGT, GST-Pi and AFP. Serum levels of GGT and GST-Pi were significantly higher in HCC patients with poorly differentiated tumors than in patients with well and moderately differentiated tumors. Treatment with adriamycin for three cycles forced a significant decrease in TNF alpha, sP-selectin and GST-Pi. We conclude that GST-Pi is superior as a diagnostic and may be a prognostic marker in HCC patients

Cyclic guanosine 3 ',5 ' - monophospha-te [cGMP] in patients with different types of acute leukemia before and after chemotherapy

Plasma cyclic guanosine 3', 5'- monophosphate [cGMP] and urinary excretion of the nucleotide were measured in patients with acute leukemia. Ten patients with acute lymphoblastic leukemia [ALL], ten with acute myetoblastic leukemia [AML] as well as ten healthy controls were enrolled in the study. Samples were measured at presentation and after completion of inducttion chemotherapy. Statistically significant elevated levels of cGMP were found in leukemic patients compared to the controls. Highly significant difference was demonstrated in comparing pre-treatment to post-treatment levels of the nucleotide. A positive correlation was found between the level of plasma cGMP and the blast count in the bone marrow. There was no statistically significant difference between the levels of cGMP in different types of leukemia [ALL versus AML]. In patients who failed to attain complete remission, the level of cGMP remained high and it rised in those who relapsed even before blast invasion. It is concluded that cGMP is a good tumour marker in acute leukemia and it is useful in monitoring response to treatment or relapse