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التغيرات الكيما حيوية في مصل الدم لتراكيز الهيبسيدين والانترلوكين - 6 نسبة لحالة الحديد قبل وبعد العلاج الكيميائي عند المرضى البالغين المصابين بسرطان الدم النيقاني الحاد == Biochemical Changes In Hepcidin And IL - 6 Concentrations Relative To Iron Status In Patients With Acute Myeloid Leukemia Before And After Treatment
Author name:
هبة عمار محمد
Supervisor name:
ختام عبد الوهاب علي | علاء فاضل علوان
General topic:
Medicine
Specific topic:
Clinical Biochemistry
Degree:
Master
University:
Mustansiriyah University - Faculty Of Medicine - Department Of Biochemistry
Language:
English
University location:
Baghdad
First pages:
19T1173 - p.pdf
Abstract:
هدف الدراسة : لتعيين العلاقة بين هرمون الهبيسيدين (hepcidin) (الهرمون المنظم لتوازن الحديد في الجسم والانترلوكين - 6 ( (interlukin - 6و علاقتها ببعض المتغيرات الكيميائية الحياتية عند المرضى المصابين بابيضاض الدم النيقاني الحاد ((AML قبل وبعد اكمال الجرعة الك | Acute myeloid leukemia (AML) is a clonal, malignant disease of hematopoietic tissues characterized by the accumulation of abnormal blast cells, especially in bone marrow, and impaired production of normal blood cells. The statistics show that this disease in men is more prevalent than women and this type of leukemia is increasing with age. Objectives : To assess biochemical changes related to iron status in acute myeloid leukemia pre and post course of chemotherapy and evaluate a relationship between serum hepcidin and IL - 6 in patients with acute myeloid leukemia pre and post chemotherapy and compare their levels to controls and their contribution on the pathogenesis of AML.Patients, Materials and Methods : The present study conducted at the National Center of Hematology and Baghdad Teaching Hospital in the Medical City from February 2014 to June 2014.The study included Fifty - eight (58) patients (30 male and 28 female) diagnosed with acute myeloid leukemia the age of patients range (15 - 65 years). Forty three (43)patients continued the study (24 male and 19 female) divided into two groups : Group (1) Patients with AML before starting chemotherapy. Group (2) the patients after 4 weeks of chemotherapy. Patient's treatment was done according to international protocol used in acute myeloid leukemia and called (3+7) where Doxorubicin was given from the first day to third day and Cyatrabine (Ara - C) was given from the first day to seventh day.Evaluationwas done on day (28) from starting chemotherapy to assess response of patients through bone marrow aspiration.All patients were subjected to complete history and physical examination. Diagnosis of AML patients was established by complete blood count and blood film, bone morrow aspiration and biopsy, hepcidin, interlukine - 6, C - reactive protein, ferritin, iron, total iron binding capacity, alkaline phosphstase, direct bilirubin were done for all patients.Forty - three (43) healthy subjects (24 male and 19 female) were enrolled in the study mainly from medical staff and their families. They were age and sex matched to patients group and considered as controls as ( Group 3).Results : • Serum hipcidin levels were significantly higher in(AML)patients (Group 2) compared to newly diagnosed(Group 1) and to healthy subjects ( P<0.0001).• Serum (IL - 6) levels were higher but not significant in(Group 1) compared to (Group 2) and significantly with healthy controls(P<0.214 and P<0.0001 respectively).• A significant increase in mean of serum ferritin levels were observed in (Group 2) compared to newly diagnosed patients (Group 1)(P<0.002) and the levels were significantly higher in newly diagnosed group compared to healthy controls (P<0.015).• Patients with (AML) during remission show significant decrease in levels of iron compared to newly diagnosed group(P<0.0001),while levels in healthy controls was higher values than both (Group 2) and (Group 1) (P<0.0001).• Total iron binding capacity (TIBC ) levels showed a significant decrease in (Group 2) after treatment compared to (Group 1) before treatment(P<0.0001) but the levels were significantly higher in healthy controls compared to (Group 1) and (Group 2) (P<0.0001).• Mean serum ALP levels showed highly increase in (Group 2) patients when compared to patients before treatment (Group 1)( P<0.0001), but the difference is not significantly higher between the newly diagnosis and controls (P<0.687).• A significant increase in mean serum direct bilirubin levels were observed in (Group 2) patients when compared to (Group 1) and healthy controls(P<0.0001).• Regarded to CRP levels in AML patients before and after treatment, the CRP levels increased in AML patients after treatment than newly diagnosed AML patients.Conclusions : Hepcidin and Interlukin - 6 may be used asprognostic for acute myeloid leukemia and also can play an important role in pathogenesis of AML.
