PROGNOSTIC IMPACT OF NEUROPILIN-1 EXPRESSION IN EGYPTIAN CHILDREN WITH B-LINEAGE ACUTE LYMPHOBLASTIC LEUKEMIA

Abstract: Background: Neuropilins are transmembrane glycoproteins that act as receptors for vascular endothelial growth factors and are involved in the process of tumor angiogenesis. Objective: The aim of this work was to study the prognostic value of neuropilin-1 (NRP-1) expression in children with B-lineage ALL. Subjects and methods: This study was conducted on fifty children with newly diagnosed B-lineage ALL who were admitted in Oncology Unit, Pediatric Department, Tanta University Hospitals in the period from August 2010 to March 2014 including 32 males and 18 females with their ages ranged from 3-17 years and mean value of 9 ± 3.5 years. Twenty healthy age and sex matched children serving as a control group was also included in this study. Patients were subjected to history taking, clinical examination and laboratory investigations including; complete blood count, serum LDH levels, bone marrow aspiration, cytochemistry, immunophenotyping and estimation of nuropilin-1 expression on blast cells by flow cytometry. Results: The present study revealed highly significant differences in NRP-1 expression between patients with B-lineage ALL and controls. The highest levels of NRP-1 expression were noted in pre-B ALL (74.04%) followed by early pre-B (23.55%) and lastly mature B-ALL (12.06%) with significant difference between the three subtypes. NRP-1 expression was significantly associated with higher white blood cells count, bone marrow blasts percentage and serum lactate dehydrogenase levels at diagnosis and there were significantly higher levels of NRP-1 expression on BM blasts at diagnosis in patients who subsequently relapsed or died later on during the period of follow up compared to those who achieved and maintained complete remission. Also, patients with higher NRP-1 expression had significantly shorter overall survival (OS) and disease free survival (DFS) than patients with low NRP-1 expression. Conclusion: Our findings suggest that neuropilin-1 has bad prognostic impact in children with B-lineage ALL and so we can recommend the incorporation of NRP-1 as a prognostic marker in children with B-lineage ALL to offer a chance for intensive therapeutic intervention in patients designated as having poor prognosis

Effect of vitamin C supplementation on lipid profile, serum uric acid, and ascorbic acid in children on hemodialysis

Children with end-stage renal disease (ESRD) suffer from dyslipidemia and hyperuricemia that might play a causal role in the progression of cardiovascular disease (CVD). The aim of the study is to assess the effects of Vitamin C supplementation on uric acid, ascorbic acid, and serum lipid levels among children on hemodialysis (HD). This prospective study was conducted in the pediatric nephrology unit at Menoufia University Hospital. The study included a total of 60 children with ESRD on maintenance HD therapy. They were divided into two groups: Group I (supplemented group, n = 30) received intravenous Vitamin C supplementation and Group II (control, n = 30) received placebo (intravenous saline) for three months. The results are shown as a mean ± standard deviation. Statistical evaluation was performed by SPSS software (version 11.5) using paired t-test. After supplementation with Vitamin C, the serum Vitamin C and high-density lipoprotein levels increased significantly with a significant reduction in the levels of serum uric acid, cholesterol, low-density lipoproteins, and triglyceride at the end of the study period. No significant changes were observed in the control group. Vitamin C can serve as a useful urate lowering medicine in HD patients to avoid complications of hyperuricemia. Furthermore, it had favorable effects on the lipid profile. This improvement can be considered as a preventive strategy in the progression of CVD in HD patients. Vitamin C supplementation improves ascorbic acid deficiency in these patients