Lipid profiles in children with acute lymphoblastic leukemia on L-asparaginase therapy

Abstract EN

Background : abnormal blood lipid profiles have been associated with many malignant diseases especially in children with acute lymphoblastic leukemia on L-asparaginase therapy Objective : to investigate the frequency and clinical significance of altered lipid profiles in children with Acute lymphoblastic leukemia (ALL) on L-asparaginase therapy Patients and Methods: A prospective study was carried out between February 2008 till January 2009 on a total of 50 patients with recently diagnosed and non-treated acute lymphoblastic leukemia who were admitted to pediatric oncology unit at Basrah Maternity and Children hospital.

Fasting blood for lipid profiles [cholesterol (CH), Triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein(LDL), very low density Lipoprotein (VLDL)] were obtained from 30 children with Acute Lymphoblastic Leukemia at diagnosis, during induction therapy with L-Asparaginase and after induction without L-Asparaginase, their ages range between (1-15) years and 20 patients were excluded because of incomplete information (noncompliance).

Results : thirty patients with Acute Lymphoblastic Leukemia (ALL) were studied, 20(66.7 %) males and 10(33.3 %) females.

An altered lipid profile was observed during therapy with L-asparaginase especially (CH, TG), the means (222.3 ± 62.9 mg / dl, 223.1 ± 88.31 mg/dl) respectively were higher than the level before the initiation of therapy (158 ± 36 mg / dl, 119.4 ± 57.3mg / dl) and after induction (139.8 ± 61.5 mg/dl, 96.2 ± 30.7 mg / dl) and these were statistically highly significant (P-value < 0.001) while no significant changes regarding other types of lipid profile.

This study showed no significant changes of lipid profiles in relation to morphological type, risk of leukemia, sex, age and body mass index (BMI), before, during and after therapy with L-Asparaginase.

Conclusion: Hyperlipidemia especially cholesterol and triglyceride levels were significantly higher during treatment with L -Asparaginse and were reversible after drug discontinuation but showed no significant correlation with age, BMI, risk group and morphological types.