[The assessment of plasma levels of insulin-like growth factor (IGF-I) and binding protein (IGFBP-3) during the maintenance therapy and after remissionof acute lymphoblastic leukemia (ALL)].

INTRODUCTION

Antineoplastic therapy may cause metabolic disturbances, which result in e.g. abnormal growth rate. The aim of the study was the assessment of IGF-1 and IGFBP-3 plasma concentrations in children after intensive therapy of ALL completed according to age, weight, height and therapy protocols (Methotrexate dose, Central Nervous System - CNS prophylaxis).

MATERIALS AND

METHODS

63 children (43 boys) were involved in this study with mean age 10.95+/-4.73 years after ALL therapy according to BFM protocols. 35 patients were in maintenance therapy and 28 completely finished the therapy. 20 children had cranial irradiation as CNS prophylaxis (12 Gy). We assessed plasma levels of IGF-1 and IGFBP-3 in radioimmunoassay method and the obtained results were related to mean age values (SDScore).

RESULTS

1. A) IGF-1 mean plasma levels in children (n=30) before puberty (Tanner I) was 151.48+/-75.75 ng/ml and was lower than compared to value in the puberty group (n=16, Tanner II-IV) - 222.06+/-96.61 ng/ml p=0.000008. After puberty (Tanner V) IGF-1 was 332.03+/-75.66 ng/ml. b) IGFBP-3 was highest after puberty (3837.4 ng/ml +/-598.49); before puberty it was 2899.68+/-656.57 ng/ml, and in puberty it was 3593.14+/-598,49 ng/ml. 2. IGF-1 SDS values were lower than mean age values. 3. IGFBP-3 SDS were insignificantly higher than mean age values. 4. There were no differences between IGF-1 SDS and IGFBP-3 SDS according to gender, prior CNS prophylaxis, methotrexate dose and phase of maintenance therapy and completed therapy. 5. IGF-1 and IGFBP-3 correlated to each other and to body mass index, height but IGF-1 SDS and IGFBP-3 SDS was independent on age, CNS prophylaxis, BMI SDS and height SDS.

CONCLUSIONS

1. IGF-1 and IGFBP-3 values are dependent on puberty degree, body mass index and height. 2. IGF-1 SDS are lower and IGFBP-3 values higher, independent on gender, therapy protocol and CNS prophylaxis (12 Gy).