Effect of some anticancer drugs on the growth of children with Acute Lymphoblastic Leukemia in Iraq

Abstract

Acute Lymphoblastic Leukemia (ALL) is the most common type of leukemia in children. It represents about 75% of all leukemia types in children less than 15 years old and peak incidence at (2-5) years old. The study was designed to evaluate the effect of chemotherapeutic regimens used for Iraqi children with ALL by assessing anthropometric parameters, oxidative state markers, and metabolic state. This prospective randomized clinical study was carried out on (30) newly diagnosed children with ALL (6 months – 8 years old) in Iraq. According to the FAB-classification, the patients grouped as L1 group (n=16) and L2 group (n=14). A healthy children (n=14) were involved and considered as a control group to compare their normal data with these of patients groups. The IGF-I, albumin, total serum protein, BMI, TAS, and LDH were determined at baseline, 1^st, 2^nd, and 3^rd months of the treatment regimen. The results showed that the mean level of serum IGF-I in both patient groups was significantly lower than that of control children at baseline, and it is increased significantly after receiving treatment while no significance difference between patients of both groups. Serum albumin, total serum protein, and BMI showed no significant differences in both patient groups when compared with the control group at baseline and after receiving treatment, also, between patients of both groups. TAS showed a significant reduction at baseline and after receiving treatment of both patients’ groups when compared with the control children, and there was a significant difference between patients of both groups. For LDH, there was a significant elevation in the mean level at baseline for both patients’ groups when compared with the control children, while after receiving treatment a significant reduction noticed in both groups when compared with control children and no significance difference between patients of both groups. These results can give indication for the effect of chemotherapy on the growth and nutrition of ALL children through their effects on IGF-I, which has a direct effect on GH and the reduction in the levels of total proteins and albumin, which may affect BMI, while the reduction in TAS during chemotherapy treatment may result in disruption of cells metabolism which will affect the normal body homeostasis.

Keywords: ALL, Growth, IGF-I, Chemotherapy.