Expression And Clinical Significance Of Interleukin-18 And Vascular Endothelial Growth Factor Of Serum In Childhood With Acute Leukemia

Objective:To determine the changes of interleukin-18(IL-18)and vascular endothelial growth factor(VEGF)levels in the serum of patients with acute leukemia(AL)in childhood,to analyze the relationship with the clinical effect and the correlated clinical indexes,and to explore their clinical significance.Methods:The levels of IL-18 and VEGF in serum were measured by sandwich enzyme-linked immunosorbent assay(ELISA)method in 45 cases of AL in childhood,which concluded 30 cases with acute lymphblastic leukemia(ALL) and 15 cases with acute non-lymphoblastic leukemia(ANLL),and 20 normal-control subjects also were detected as comparison.At the same time to analyze the change of IL-18 and VEGF in serum with 32 cases of prior and post treatment,as well as the relationship with the clinical effect to treatment and the clinical indexes.Results:1.The serum levels of IL-18(719.35±358.21 pg/ml)and VEGF(145.88±67.67pg/ml)in the new diagnoses AL group were significantly higher than those of normal-control group(311.80±146.64pg/ml,56.44±26.78pg/ml)(both P＜0.01);In the new diagnoses ALL and ANLL group,the serum levels of IL-18 (680.83±256.33pg/ml,796.38±361.55pg/ml)and VEGF(149.77±71.65 pg/mL,138.09±60.50pg/ml)were also significantly higher than those of normal-control group(P＜0.01),but there were no significant(P＞0.05)between the new diagnoses ALL and ANLL group.2.After treatment in 32 cases,the serum levels of IL-18(401.14±180.78 pg/ml)and VEGF(92.83±39.77pg/ml)were decreased in post-treatment CR group,which were significantly different compared to prior-treatment(563.84±230.82 pg/ml,139.13±59.21pg/ml)(P＜0.01);while the serum levels of IL-18 were no significant compared to normal-control group,but those of VEGF were significantly higher than normal-control group(P＜0.01).The serum levels of IL-18(813.40±203.24pg/ml)and VEGF(115.89±41.33pg/ml)in nonremission group were higher than those of normal-control(P＜0.05);while compared to prior-treatment group(885.53±378.34pg/ml,120.96±48.27 pg/ml),the differences were no significant(P＞0.05).The serum levels of IL-18 and VEGF in CR group were lower than in non-remission group,and the differences were significant(P＜0.05).3.According to the clinical sub-group with risk factors in the new diagnoses AL in childhood,the serum levels of IL-18 in HR(878.64±405.86 pg/ml)and MR group(767.95±341.61pg/ml)were significantly higher than those in LR group(524.74±216.70pg/ml),which were significantly different (P＜0.05)and no significantly different between MR and HR group(P＞0.05). The serum levels of VEGF in three sub-group were no significant(P＞0.05).In in the new diagnoses ALL,the serum levels of IL-18 in T-ALL group(1015.78±329.17pg/ml)were significantly higher than those in B-ALL group(537.28±261.99pg/ml)(P＜0.05);while the serum levels of VEGF were no significant between T-ALL group and B-ALL group(P＞0.05). 4.The serum levels of IL-18 and VEGF in the new diagnoses AL were correlated with the count of blast cells in bone marrow(r=0.411,r=0.301),but were irrelevant to sex,age,the count of white cells,red cells,platelet and the hemoglobin levels in peripheral blood(P＞0.05);the serum levels of IL-18 were irrelevant to those of VEGF in prior-treatment AL(P＞0.05).Conclusion:1.The patients with AL in childhood had the abnormal expression of IL-18 and VEGF,and there were no significantly different in the levels of IL-18 and VEGF between the new diagnoses ALL and ANLL.It indicated that IL-18 and VEGF might be relevant to the growth and multiplication of leukemia cell in childhood AL.2.The serum levels of IL-18 and VEGF in the patients with childhood AL were related to the clinical treating effect and bone marrow juvenile cell.So dynamically testing the change of serum levels of IL-18 and VEGF could help to get further knowledge of the quantity of leukemia cell and the effect of treatment.3.The expression levels of IL-18 in T-ALL group were significant higher than those in B-ALL group.4.The serum levels of IL-18 were related to the clinical risk factor in prior-treatment AL,and the serum levels of IL-18 in HR and MR group were significangtly higher than those LR group.