Immunoglobulins and immunoglobulin G subclasses with vitamin E level in children with acute lymphoblastic leukaemia

ABSTRACT

This study was conducted to assess the effect of acute lymphoblastic leukaemia as a disease and cytotoxic therapy on serum levels of total immunoglobulin G and immunoglobulin G subclasses [Gl, G2, G3, G4], with IgA, IgM complements C3, C4 and vitamin E [as an endogenous antioxidant] in children with acute lymphoblastic leukemia. Twenty-six children with acute lymphoblastic leukemia completed the study, which was conducted in the Hospital of Nuclear Medicine in Mosul city from Jun 2005 to Apr 2007. Also included in the study a 27 apparently healthy age and sex matched children serve as a control for the initial laboratory results. Initially for both the patients and controls, a blood sample withdrawn and serum total immunoglobulin G, subclasses [Gl, G2, G3, G4], immunoglobulin A, immunoglobulin M, complements C3, C4 and vitamin E was measured [immunoglobulin groups, and subclasses of IgG with the complements C3, C4 using radial immunodiffusion methodology with specific kits, while serum vitamin E was measured by high performance liquid chromatography]. For the patient's group the same parameters were measured after receiving the cytotoxic therapy for the induction remission and consolidation phases of therapy. For the children with acute lymphoblastic leukaemia, before starting cytotoxic regimen, there was a significant differences in total immunoglobulin G, immunoglobulin G2, immunoglobulin G4, Complements C3 and C4, with insignificant differences in the serum levels of immunoglobulin Gl, immunoglobulin G3, immunoglobulin A and M with serum vitamin E, from values in the control group. After receiving cytotoxic therapy and in comparison to the initial control results, there was a significant difference in the mean serum level total immunoglobulin G subclasses Gl, G2, G3, and G4 and complement C3. While serum levels of immunoglobulin A and M, complement C4 and vitamin E showed insignificant differences from the control values. By comparing results of children with acute lymphoblastic leukaemia before and after starting cytotoxic therapy, serum total immunoglobulin G and subclasses G2, G4, showed a significant reduction after cytotoxic therapy, so as immunoglobulin A and M, complements C3, C4 and vitamin E levels. Where as immunoglobulin G subclass Gl and G3 showed insignificant differences. Acute lymphoblastic leukaemia as a disease and cytotoxic therapy do affect humoral immunity as reflected by their effects on immunoglobulin G total and subclasses [mainly IgG2 and IgG4], IgA and IgM with the complements C3 and C4, also there is an obvious and negative effects of cytotoxic therapy on serum vitamin E as an endogenous antioxidant in children with acute lymphoblastic leukaemia