Change of lipid profile in children with acute lymphoblastic leukemia due to induction chemotherapy in a tertiary care hospital of Bangladesh

Abstract

Background: Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy. In the Department of Paediatric Haematology and Oncology of Bangabandhu Sheikh Mujib Medical University (BSMMU), 58% of ALL cases were recorded among 455 newly diagnosed malignancy patients in a single year. Studies found that remarkable hypertriglyceridemia occurs with L-asparaginase therapy and steroid. This study was done to evaluate the changes of serum total cholesterol, triglycerides (TG), high density lipoprotein (HDL), and low-density lipoprotein (LDL) during and after induction chemotherapy in children with ALL.

Methods: This prospective observational study was performed in the Department of Pediatric Hematology and Oncology of BSMMU from March-November 2013. Newly diagnosed acute lymphoblastic leukemia patients aged 3-15 years were included in this study after having written consent from the parents of the participants to participate in the study and enrolled for the treatment of ALL (according to modified UKALL 2003 protocol).

Results: Total cholesterol, TG, HDL, and LDL changed significantly due to induction therapy. Serum total cholesterol and LDL decreased after completion of L-asparaginse in comparison to before induction, increased significantly after completion of induction in comparison to after completion of L-asparaginase (P=0.001), and increased significantly after induction in relation to before induction therapy (P=0.003). TG decreased significantly (P=0.033) after completion of L-asparaginase than before induction but increased after completion of induction. HDL increased after completion of L-asparaginase and after induction significantly (P=0.001). LDL decreased after completion of L asparaginase which was significant (P=0.005).

Conclusion: After induction chemotherapy, total cholesterol, HDL and LDL level increased and TG level decreased among ALL patients.