الفهرس 
Acute leukemiaOnly 14 pages are availabe for public view
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Abstract
Acute leukemia is characterized by a rapid increase in the number of immature blood cells. Crowding of such immature cells makes the bone marrow unable to produce healthy blood cells. Immediate treatment is required in acute leukemia due to the rapid progression and accumulation of the malignant cells, which then spill over into the blood stream and spread to other organs of the body. Acute forms of leukemia are the most common forms of leukemia in children. There are two main types of leukemia in children: acute lymphoblastic, is characterized by disordered differentiation of eitherlymphopoietic stem cells, and myelogenous leukemia which is characterized by disordered differentiation of hemopoietic stem cells. Acute lymphoblastic leukemia (ALL) is the most common type of leukemia diagnosed in childhood. About 80 percent of leukemia diagnosed in children is ALL. The incidence of childhood leukemia varies with age. The risk of acute lymphoblastic leukemia increases rapidly after birth, peaks around the third or fourth year of life and then declines. This is known as the early childhood peak. Hepcidin, predominantly produced in the liver, has turned out to be a key iron regulator in humans by binding to ferroportin, the only known cellular iron exporter in vertebrates and causes its internalization, thus decreasing iron efflux from iron exporting tissues into plasma. Hepcidin expression is up-regulated by iron, cytokines (IL-1 and IL-6) and by the bone morphogenetic proteins (BMPs). It is down- regulated by anemia and hypoxia.Dysregulation of hepcidin or its receptor ferroportin results in a spectrum of iron disorders. However, there is ascant information on hepcidin expression in acute leukemia (AL). The current study was carried out at the Medical Biochemistry and Pediatric Departments, Faculty of Medicine, Menofia University. The aim of this study was to evaluate the role of hepcidin in acute lymphoblastic leukemia in children. Full history and clinical examination were made to every subject. Laboratory investigations were also carried out to all individuals including: Complete blood count (CBC), serum hepcidin, serum ferritin, serum uric acid, Liver function tests (ALT, AST and bilirubin), Renal function tests (BUN and creatinine level) and Electrolytes: (Na, K, Ca, P). The results of the present study can be summerized as follows: • New cases of ALL had statistically highly significant clinical criteria (Lymphadenopathy, hepatosplenomegaly, bleeding and pallor) than complete remission, maintenance and control groups. • Children patients at time of diagnosis had significantly decreased values of Hb, platelets count, RBCs count and reticulocytic count than after complete remission, while they had significantly increased values of WBCs and serum ferritin than after complete remission. ALT and AST were not significantly different before and after remission. • Children patients at time of diagnosis had significantly increased lymphoblastic (%), it was 70-90% in 25% and > 90% in 75% of cases. There was significant statistical difference between GI and GII regarding lymphoblasts(%). • Children patients at time of diagnosis had significantly increased serum hepcidin and serum ferritin levels than after complete remission. • Children patients after complete remission had significantly increased serum hepcidin and serum ferritin levels than maintenance group. • Children patients after maintenance had increased serum hepcidin and serum ferritin levels than control group. • Children patients after remission had significantly decreased values of Hb, platelets count, RBCs count and potassium than control group. While they had significantly increased values of WBCs, ALT, AST and serum ferritin than control group. Reticulocytic count was not significantly different between two groups. • In new cases of ALL, hepcidin had significant negative correlation with hemoglobin and reticulocytic count and significant positive correlation with serum ferritin while non significant correlation between hepcidin and other laboratory parameters among newly diagnosed cases of leukemic patients. • In new cases of ALL, ferritin had significant negative correlation with hemoglobin, reticulocytic count, RBCs and WBCc count, while non significant correlation between ferritin and other laboratory parameters among newly diagnosed cases of leukemic patients.