Academic journal article Iranian Journal of Public Health

Serum Adiponectin and Resistin Levels in De Novo and Relapsed Acute Lymphoblastic Leukemia Children Patients

Academic journal article Iranian Journal of Public Health

Serum Adiponectin and Resistin Levels in De Novo and Relapsed Acute Lymphoblastic Leukemia Children Patients

Article excerpt


Background: Adipose tissue secretes a large number of adipocytokines such as leptin, resistin, and adiponectin. Many of these hormones and cytokines are altered in obese individuals and may lead to disruption of the normal balance between cell proliferation, differentiation, and apoptosis. The aim of our work was to investigate the disturbance of secretion of adiponectin and resistin in de novo and relapsed acute lymphoblastic leukemia (ALL) in Egyptian children and determine whether adiponectin and resistin are implicated in increased risk relapse compared to healthy individuals.

Methods: Measurements of adiponectin and resistin were performed at diagnosis, in 32 patients with de novo ALL aged 3 to 18 years (mean 9.8 y) and 19 children with relapsed ALL aged 5 to 17 (mean 9.9 yr). 10 apparently healthy children with matched age and sex were used as controls.

Results: Mean adiponectin levels were low (P < 0.05), whereas mean resistin levels were high (P<0.05) at diagnosis and relapsed ALL (compared to healthy controls). A significant decrease of adiponectin levels was observed in relapsed ALL compared to de novo ALL. In contrast resistin was significantly increased in relapsed ALL compared to de novo patients. Adiponectin in ALL subjects inversely correlated with resistin level (r = -0.51, P < 0.001).

Conclusion: Low adiponectin and high resistin level at diagnosis suggest their implication in ALL pathogenesis and may serve as potential clinically significant diagnostic markers to detect leukemic relapse.

Keywords: Acute lymphoblastic leukemia, Adiponectin, Resistin


Leukemias strike males and females in all ages and represent about one-third of childhood cancers. The most common type is childhood acute lym-phoblastic leukemia (also called acute lymphocytic leukemia or ALL). ALL is a fast growing cancer with an overproduction of abnormal immature white blood cells, called lymphoblasts or leukemic blasts. This type of leukemia usually affects chil-dren ages 1 - 10 years (1). Relapsed, recurrence leukemia can occur during therapy or after com-pletion of treatment and represents the main cause for treatment failure (2).

In Egypt about four new cases of ALL per 100.000 children are diagnosed each year in the National Cancer Institute (NCI), Cairo University. It comprises about 30% of all pediatric malignan-cies and 70% of pediatric leukemia. In children between the ages of 2 and 10 ALL is the predomi-nant form of leukemia with higher rates in males than females (3, 4).

Several studies confirm that altered secretion of the adipocytokines from adipose tissue is believed to increase the risk of various types of cancer. Leptin and adiponectin, adipocyte secreted hor-mones, are well-studied factors relation to malig-nancies. Leptin was found to be inversely associ-ated with risk of chronic lymphocytic leukemia (CLL), however, no significant association be-tween CLL and adiponectin (5). Among the path-ophysiological mechanisms underlying the associa-tion between obesity and cancers are insulin re-sistance (6), low-grade systemic inflammation (7), and altered secretion of adipokines (8), though the mechanisms may differ between different types of cancer. The link between insulin resistance and cancer may be related to the compensatory hyperinsulinemia. High concentration of circu-lating insulin may signal cells to proliferate through different mechanisms either by directly signaling growth, or by increasing the levels of other more potent growth factors. Insulin-like growth factors (IGF) is one of the growth factors that have an important pathogenic role in cancers through promoting cell proliferation and decreas-ing apoptosis (6).

Adiponectin, a hormone exclusively derived from adipocyte and secreted in high concentration into the blood (9). Previous studies postulated an in-verse relation between serum levels of adiponectin and the risk of breast, endometrial, prostate, colo-rectal, kidney cancer and acute myeloid leukemia (AML) in children (10-15). …

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