Analysis Of The Correlation Between Serum Thymidine Kinase1 And Acute Myeloid Leukemia

【Objective】This study was performed to approach clinical significance of serum thymidine kinase 1(STK1) level change in acute myeloid leukemia(AML).【Methods】Peripheral blood samples of 60 newly diagnosed AML patients at the First Affiliated Hospital of Soochow University between Mar 2010 and Mar 2011 were available before and two weeks after start of inductive treatment and maintenance treatment .The STK1 levels were determined by enhanced chemiluminescent dot-blot assay. This study consists of several phases. Compare the STK1 levels of AML patients with that of health persons. Then, sera from the 60 de novo AML patients were grouped according to clinical status ( pretreatment, complete remission(CR), partial remission(PR), non-remission (NR)and Relapse ) and analyzed against health controls. Collecting the clinical and lab data of these cases, and then analyzed the correlation between STK1 and their clinical characteristics. Analyzed the effect of STK1 level in chromosomal abnormalities, gender, age at diagnosis, the peripheral WBC count, hemoglobin level and platelet count, serum lactate dehydrogenase (LDH) level and whether had fever of onset groups with respect to the 49 AML patients except M3 ones. Then the possibility of interaction between STK1 level and M3 subgroup classified by the peripheral WBC count and platelet count of onset was analyzed alone.【Results】A statistically significant difference (P<0.001) for the mean STK1 level existed between 60 de novo patients and health controls. However, there was no significant difference (P=0.359) in STK1 was found among the FAB subgroups of these patients.Follow up these 60 patients who had received standard chemotherapy to estimate the clinical prognosis: 33 patients got CR, but 5 of them relapsed into progressive disease, 10 patients got PR and 17 patients failed to achieve remission. The mean STK1 level dropped lower in CR patients (P<0.05) compared with pretreatment, PR, NR as well as relapse groups. However, NR patients were not significantly different (P>0.05) from either PR or pretreatment ones with respect to STK1 level.The 49 AML patients except M3 ones were further analyzed concerning the correlation between STK1 and their clinical characteristics.A significant correlation was found between STK1 and chromosomal abnormalities. Patients with unfavorable cytogenetic aberrations had higher STK1 concentration than those with favorable cytogenetics (P=0.029).Strong correlations between STK1 and both serum lactate dehydrogenase (LDH) level and whether had fever of onset were also observed (P<0.05). But the STK1 level was not noticeable different (P>0.05) between groups of gender (male vs. female), age (≥60 vs.<60 years), the peripheral WBC count (≥50×10E9/L vs.<50×10E9/L), hemoglobin level (≥100g/L vs.<100g/L) and platelet count (≥100×10E9/L vs.<100×10E9/L) of the 49 ones.The effect of STK1 level for 11 M3 patients out of 60 ones was analyzed alone. According to the peripheral WBC count and platelet count of onset, M3 subgroup was classified into high risk (4/11), intermediate risk (5/11) and low risk (2/11) groups. Though there was not a significant correlation observed (P>0.05) between STK1 concentration and the different risk groups, the positive proportion of STK1 was significantly increased in the high risk group compared to the other two groups, respectively.【Conclusions】The serum TK1 level in CR or PR AML patients decreased in varying degree compared to pretreatment, while there was no significant difference for NR ones. CR patients for serum TK1 remained low level but increased noticeably as one who relapsed into progressive disease. A significant correlation was found between STK1 and chromosomal abnormalities, serum LDH level as well as whether had fever of de novo AML patients.It was showed that the serum TK1 level change might be applied for reflecting the aggressiveness of disease, monitoring the clinical response to chemotherapeutic treatment and indicating the prognostic value. Besides, Long-term monitoring of the serum TK1 concentration would also allow the clinician to detect possible relapse in patients if TK1 levels start to increase.