Changes In25-Hydroxyvitamin D₃Levels And Clinical Significance In Children With Acute Leukemia Before And After Chemotherapy

Background:Acute leukemia is a malignant blood system disease in children.In recentyears,survial of acute leukemia patients has become prolonged and5yearsevent-free survial had significantly increased with the application of intensivechemotherapy.However, the prognosis of some patients is still poor,andcurrently we know little about the pathogenesis of this disease.Several reportssuggested that vitamin D had a central role in maintaining serum calciun andphosphorus.Meanwhile, it has been showed that vitamin D can regulate theimmune, prevent cancer by keeping cellular proliferation and differentiation, andinduce cellelar apoptosis.And it can help to prevent the activition of telomeraseand metastasis, invasion and angiogenesis of tumor.Epidemiologic studies havedrawn that levels of vitamin D was related to risk and prognosis of the malignantdiseases.So far,there is little research about vitamin D and childhood acuteleukemia both at home and abroad.To sum up,25-（OH） D₃was measured atdifferent time and compared before and after chemotherapy. Accordingly theprotential role of25-（OH） D₃in the pathogenesis,treatment and prognosis ofacute leukemia was investigated.Objective:To investigate25-（OH） D₃levels in patients with new-onset acuteleukemia and changes in25-（OH） D₃levels in children with acute leukemiabefore and after chemotherapy. Accordingly the protential role of25-（OH） D₃in the pathogenesis,treatment and prognosis of acute leukemia was investigated. Method:We enrolled46patients, aged2to12years, who are new-onset acuteleukemia（including38ALL and8AML）,and31healthy children, aged2to11years are collected as the control group. The serum25-（OH） D₃levels in all thechildren were measured using tandem mass spectrometry.At the same time, theconcentration of serum Ca、P、ALP and PTH both in experimental and controlgroup is measured. Then the patients with acute leukemia received intensivechemotherapy,and the serum25-（OH） D₃levels in the patients with acuteleukemia were measured after6months and12months chemotherapy.Results：1.The serum25-（OH） D₃levels in cases with new-onset acutelymphoblastic leukemia are lower than the control group,and the difference wassignificant （p <0.01）.2. The serum25-（OH） D₃levels in cases with new-onset acute myelocyticleukemia are lower than the control group,and the difference was significant （p<0.05）.3.No difference was noted in the serum25-（OH） D₃levels between thecases with new-onset acute lymphoblastic leukemia and acute myelocyticleukemia （p>0.05）.4. No difference was noted in the serum25-（OH） D₃levels among thecases with new-onset acute lymphoblastic leukemia of different risk types （p>0.05）.5. No difference was noted in the serum Ca、P、ALP and PTH levelsbetween the cases with new-onset acute leukemia and the control group（p>0.05）.6. The serum25-（OH） D₃levels in cases with acute leukemia increasedafter receiving6months and12months chemotherapy,and the difference was very significant （p <0.05）.And no difference was noted in the serum25-（OH）D₃levels between the cases with acute leukemia and control group（p>0.05）.Conclusion:1.The serum25-（OH） D₃levels in cases with new-onset acute leukemiaare lower than the healthy children.2. The serum25-（OH） D₃levels in cases with acute leukemia significantlyincreased after chemotherapy,and no difference was noted between the patientsand healthy children.3. The serum25-（OH） D₃levels are not associated with risk types ofpatients with acute lymphoblastic leukemia.4. The serum25-（OH） D₃levels in patients with new-onset acuteleukemia did not affect their serum Ca、P、ALP and PTH levels.