Cancers · 2024
Changes in RANKL, OPG, and 25(OH)D Levels in Children with Leukemia from Diagnosis to Remission.
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Atilano-Miguel Salvador, Barbosa-Cortés Lourdes, Ortiz-Muñiz Rocío, Maldonado-Hernández Jorge, Martin-Trejo Jorge A, Rodríguez-Cruz Maricela, Balcázar-Hernández Lourdes, Solís-Labastida Karina A, Bautista-Martínez Benito A, Juárez-Moya Azalia, Hernández-Piñón Zayra, Galindo-Rodríguez Raeline A, Chávez-Anaya Adriana, Valdez-Avilez Rosa E, Domínguez-Salgado Juan M, Villa-Morales Judith, Rodríguez-Palacios María E
Аннотация
BACKGROUND: The receptor activator of the nuclear factor-kB (RANK)/RANK ligand (RANKL)/osteoprotegerin (OPG) pathway is a determining pathway in the balance between bone formation and resorption, and disruptions in this complex can affect bone metabolism.
METHODS: This study analyzes the changes in RANKL, OPG, and 25(OH)D levels; the RANKL/OPG ratio; and other bone turnover markers (BTMs) from diagnosis to complete remission in children with acute lymphoblastic leukemia (ALL). This is a prospective observational cohort study, carried out at the Instituto Mexicano del Seguro Social, Mexico City, including 33 patients (4-17 years) with newly diagnosed B-cell ALL. The patients were treated with the HP09 chemotherapy protocol. Children who had previously been treated with corticosteroids were excluded. A peripheral blood sample at diagnosis and remission was collected to determine the 25(OH)D and BTM concentrations.
RESULTS: Increased RANKL (p = 0.001) and osteocalcin (p < 0.001) levels and RANKL/OPG ratio (<0.001) and a decreased OPG level (p = 0.005) were observed at remission, predominantly in the high-risk (HR) relapse and vitamin D deficiency groups. A negative association between RANKL and OPG (r = -0.454, p = 0.008) was observed.
CONCLUSIONS: we suggest that the RANKL/OPG ratio could serve as a bone remodeling marker in ALL patients.
METHODS: This study analyzes the changes in RANKL, OPG, and 25(OH)D levels; the RANKL/OPG ratio; and other bone turnover markers (BTMs) from diagnosis to complete remission in children with acute lymphoblastic leukemia (ALL). This is a prospective observational cohort study, carried out at the Instituto Mexicano del Seguro Social, Mexico City, including 33 patients (4-17 years) with newly diagnosed B-cell ALL. The patients were treated with the HP09 chemotherapy protocol. Children who had previously been treated with corticosteroids were excluded. A peripheral blood sample at diagnosis and remission was collected to determine the 25(OH)D and BTM concentrations.
RESULTS: Increased RANKL (p = 0.001) and osteocalcin (p < 0.001) levels and RANKL/OPG ratio (<0.001) and a decreased OPG level (p = 0.005) were observed at remission, predominantly in the high-risk (HR) relapse and vitamin D deficiency groups. A negative association between RANKL and OPG (r = -0.454, p = 0.008) was observed.
CONCLUSIONS: we suggest that the RANKL/OPG ratio could serve as a bone remodeling marker in ALL patients.