Abstract

Background: One of the most common cancers in children is acute lymphoblastic leukemia (ALL). Treatment has been developed, but the treatment still leads to relapse in children. lactate dehydrogenase (LDH) and ferritin play an important role in Acute lymphoblastic leukemia.
Aim: Our current study aimed to evaluate serum level of LDH, ferritin, GH and CRP in Iraqi Acute lymphoblastic leukemia patients before treatment (new case) and after achieving clinical remission (after treatment).
Patients and Methods: This study included 120 children, including 80 children with Acute lymphoblastic leukemia of both sexes (48 males, 32 females, ages 11 to 18) who were visiting Ibn al-Atheer Children’s Educational Hospital in Mosul, Iraq. Forty uninfected children of identical age (23 males and 17 females) were considered as a control group. In addition, the group of patients was divided into two groups, the first newly diagnosed (before treatment) and the second patients after treatment arrive in a state of remission. Serum lactate dehydrogenase, ferritin, growth hormone and c-reactive protein were measured.
Results: The finding of our study showed that the mean age for patients with ALL was 14.1±1.7 years, and the average age of healthy persons is 14.6±1.8 years. The results indicated that Acute lymphoblastic leukemia patients have a significant increase (P<0.0001) in level activity of lactate dehydrogenase (721.3±329.3 U/L, ALL patients versus 177± 17 U/L controls), and ferritin (251.5±124.1 ng/ml ALL patients versus 51.8±7.3ng/ml controls) compared to healthy children.
 Also, the results indicated that ALL patients before treatment have a significant increase (P≤ 0.0001) in level activity of LDH (1260.2±287.0 U/L; 182.5±41.9) ferritin (450.9±171.7ng/ml; 52.1±5.6ng/) and growth hormone (9.4±1.3ng/ml 7.5±2.5 ng/ml) compared to patients after treatment arrive in a state of remission, respectively.
While there was no significant difference was shown in the level of LDH, ferritin, LDH and CRP between patients after treatment and healthy children.
Conclusion: Serum lactate dehydrogenase and ferritin levels in patients with acute lymphoblastic leukemia at an early stage are significantly increased, while its fall to the normal value in patients at clinical remission. So measurement and surveillance of changes in serum LDH and ferritin levels could be helpful for easy and simple assessing and prognosis of the disease in these patients. Also, changing the level of growth hormone before and after treatment may help in estimating the condition and predicting the response to chemotherapy.

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