Endothelial Function in Children with Acute Lymphoblastic Leukemia (ALL) May Reflect the Clinical Outcome

Area of Science:

• Pediatric Oncology
• Hematology
• Vascular Biology

Background:

• Endothelial dysfunction is a recognized complication in hemato-oncologic therapies.
• Early detection of endothelial dysfunction is crucial for managing acute lymphoblastic leukemia (ALL) and its complications.

Purpose of the Study:

• To evaluate endothelial function markers at diagnosis and during early treatment in pediatric ALL patients.
• To determine the correlation between endothelial function profiles and early clinical outcomes (ECO) in ALL.

Main Methods:

• Recruited 28 children with ALL and 18 healthy controls.
• Assessed endothelial function markers (sP-selectin, PAI-1, sE-selectin, sICAM-1, sVCAM-1, VEGF) at baseline, day 33, and day 78 of treatment.
• Correlated marker levels with treatment response and survival.

Main Results:

• Children with ALL exhibited higher baseline sICAM-1 and sVCAM-1, and lower sP-selectin and VEGF compared to controls.
• Successful treatment correlated with decreasing sICAM-1, sVCAM-1, and sE-selectin levels.
• Unsuccessful treatment was associated with higher sE-selectin and lower baseline sICAM-1.
• Lower PAI-1 levels were observed in survivors.
• A decrease in sE-selectin and lower PAI-1 at day 78 predicted better ECO.

Conclusions:

• Baseline levels of sICAM-1, sVCAM-1, sE-selectin, and VEGF are altered in pediatric ALL patients.
• Specific changes in endothelial markers during therapy correlate with treatment success and prognosis.
• Endothelial dysfunction markers hold prognostic value for early clinical outcome in pediatric ALL.