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

ABSTRACT

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