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Erythrocyte pyruvate kinase activity during chemotherapy in children with leukemia and lymphoma
H L Yilmaz1, A Tanyeli, H Ozüsaglam
1Unit of Pediatric Emergency Medicine, Department of Emergency Medicine, Medical Faculty of Cukurova University, Adana, Turkey. hyilmaz@mail.cu.edu.tr
Insights
Erythrocyte pyruvate kinase activity (ePKA) is lower in patients with acute leukemia and lymphoma at diagnosis. ePKA levels normalize after chemotherapy, suggesting its potential use in monitoring cancer treatment.
Area of Science:
- Biochemistry
- Hematology
- Oncology
Background:
- Erythrocyte pyruvate kinase activity (ePKA) is a key enzyme in glycolysis.
- Altered ePKA levels have been observed in various hematological malignancies.
Purpose of the Study:
- To determine ePKA levels in patients with acute leukemia and lymphoma at diagnosis.
- To investigate changes in ePKA profiles during malignant disease and chemotherapy.
Main Methods:
- Prospective, longitudinal study of 57 patients with acute lymphoblastic leukemia (ALL), lymphoma, or relapsed ALL.
- Comparison with 42 healthy children as controls.
- Serial blood sampling (5 times, 1.5 months apart) for ePKA measurement and statistical analysis.
Main Results:
- Lower ePKA at diagnosis in patients with ALL (p=0.003) and relapsed ALL (p=0.001) compared to controls.
- No significant difference in ePKA at diagnosis for lymphoma patients.
- Significant ePKA increase from diagnosis to third sample in ALL (p=0.006) and lymphoma (p=0.047) patients.
Conclusions:
- ePKA is reduced in leukemia and relapsed ALL at diagnosis.
- ePKA levels tend to normalize after chemotherapy.
- ePKA measurement may serve as a potential biomarker for monitoring neoplastic treatment response.
Objectives:
To determine both erythrocyte pyruvate kinase activity (ePKA) at the time of diagnosis of patients with acute leukemia or lymphoma and the differences in the ePKA profiles during the malignant disease and its chemotherapy.
Methods:
A prospective, longitudinal clinical study was performed involving 57 patients, 10 were the ones with relapse of acute lymphoblastic leukemia, 32 were the ones with acute lymphoblastic leukemia (ALL) and 15 were the ones with lymphoma. None of the subjects in this study group received treatment or blood transfusion before the study, except the ones diagnosed with relapse of ALL. Forty two healthy children were also selected to form the control group. In order to measure ePKA, blood samples were taken for five times, with 1.5 months apart between each other during the study. Statistical analysis were done by using Wilcoxon's signed rank test, Kruskall-Wallis with Mann-Whitney U Test and Spearman rank correlation coefficient test.
Results:
The ePKA of the patients with relapse of ALL, and ALL, but not the patients with lymphoma, at the time of diagnosis were found to be lower compared to the one's in the control group (respectively p = 0.001, p = 0.003). The comparison between the first ePKA samples and the third ePKA samples of the patients with both ALL and lymphoma showed a significant increase (respectively p = 0.006, and p = 0.047).
Conclusion:
The measurement of ePKA can be considered for follow-up the neoplastic treatment due to the fact that it is detected to be low in leukemia and relapse of ALL and in normal values after chemotherapy. However, more long-term studies, including more number of cases, are required to be carried out in order to prove the accuracy of this hypothesis. (Tab. 2, Fig. 1, Ref. 28.)
