Abstract
Background: Abnormal lipid profile has been associated with cancers, including acute lymphoblastic leukemia ALL, the most common form of malignant disease in the paediatric age group; also, drugs used in induction therapy affects the lipid profile. Objective: The objective of this study was to investigate the frequency of altered lipid profiles in children with (ALL) at diagnosis and after induction therapy. Patients and methods: Fasting lipid profile (s. cholesterol, sTG, HDL-C, LDL-C) for about 10-12 hours has been obtained from each patient In this case-control study. Lipid profiles of 26 cases with newly diagnosed ALL (13 males and 13 females) were compared with those of 40 healthy controls (20 males and 20 females) of the same age and gender from the 1st of February to the 31st of October 2010, then we compare lipid profile readings of 21 ALL with lipid profile readings of the same patients after completion induction therapy (we excluded 5 ALL cases who died before starting induction therapy). Results: The lipid profiles in the newly diagnosed ALL patients at diagnosis showed the following values: s.cholesterol 153.8±41 mg/dl, sTG 176.8±97.9mg/dl, HDL-C 38.5±15.5mg/dl, and LDL-C 88.3±41.5 mg/dl, the lipid profiles after induction therapy showed s.cholesterol 168.5±51.6 mg/dl, sTG 212.1±100.25mg/dl, HDL-C32.1±14.05mg/dl and LDL-C 104.4±41.34mg/dl, whereas for controls they were 144.02±22.9mg/dl, 106.8±48.8mg/dl, 34.1± 7.3mg/dl, 88.9±27.2mg/dl respectively. Abnormalities in lipid profiles regarding s TG showed that it was significantly higher in newly diagnosed ALL in comparism to controls, while s. cholesterol and HDL-C were higher among the patients, but it was statistically not significant, and LDL-C seems to be similar or slightly higher than controls, but they were not significant. Results showed that there were significant elevations in sTG and LDL-C in the patients after induction therapy compared to a diagnosis, whereas there was a significant reduction in HDL-C after induction therapy compared to the readings at diagnosis. Conclusion It can be concluded from this study that at the moment of diagnosis, a change in lipid profile could be established and might be atherogenic. And these changes include a significant elevation of s TG, and while other changes like s. cholesterol and HDL elevations were not significant statistically. Lipid profile alteration presents specifically during combination therapy of l-asparaginase and steroids in induction therapy in ALL patients, which includes further elevations of s TG, LDL, and reduced HDL, and as we know that, these changes might be atherogenic
Keywords
Lymphoblastic Leukemia, HDL-C, LDL-C, ALL