Time course of changes in iron metabolic and oxidative-antioxidative system parameters in patients with acute myeloid leukemia


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AIM: To study an association between iron metabolism, free radical oxidation (FRO), and antioxidative system (AOS) in patients with acute myeloid leukemia (AML) during intensive chemotherapy/MATERIAL AND METHODS: AML patients (n=14) with a median age of 46 years received 7+3 courses (n=3) containing cytarabine ≥1 g/m2/introduction (n=8) and myeloablative conditioning regimen before hematopoietic stem cell transplantation (n=3). The concentrations of iron, ferritin, transferrin saturation (TFS), and malonic dialdehyde and the activity of superoxide dismutase (SOD), ceruloplasmin (CP), and catalase were investigated in their sera. The investigations were performed before and after chemotherapy and during hemopoietic recovery and rehospitalization/RESULTS: After therapy termination, there was a significant increase in TFS (6.8% vs 41.9%; p<0.0001), which gave way to its reduction during hemopoietic recovery (89.5% vs 96.8%; p=0.003). The activity of antioxidant enzymes was found to be altered at a time. That of catalase was enhanced throughout cytopenia (3.8 and 3.3 vs 5.7 conventional units (CU)/ml; р=0.028 and р=0.011). The lower activity of SOD (21.0 vs 41.0 CU/ml; p=0.018) and the higher activity of CP (1.1 vs 0.8 g/l) were ascertained when leukocyte count increased up to ≥1·109/l/CONCLUSION: After intensive cytostatic therapy, there was a phasic TFS increase accompanied by the compensatory change in AOS activity, which is aimed at neutralizing FRO products.

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Динамика показателей обмена железа и окислительно-антиокислительной системы у больных острыми миелоидными лейкозами. - Резюме. Цель исследования. Изучить сопряженность обмена железа, свободнорадикального окисления (СРО) и антиоксидантной системы (АОС) у больных острыми миелоидными лейкозами (ОМЛ) при проведении интенсивной химиотерапии. Материалы и методы. Больным ОМЛ (n=14) с медианой возраста 46 лет провели курсы "7+3" (n=3), содержащие цитарабин ≥1 г/м2/введение (n=8), и миелоаблативный режим кондиционирования до трансплантации гемопоэтических стволовых клеток (n=3). В сыворотке крови исследовали концентрацию железа, ферритина, насыщения трансферрина железом (НТЖ), малонового диальдегида (МДА) и активность супероксиддисмутазы (СОД), церулоплазмина (ЦП) и каталазы. Исследования выполняли до химиотерапии и после ее завершения, а также при восстановлении гемопоэза и повторной госпитализации. Результаты. После окончания терапии выявлено достоверное повышение НТЖ (6,8% против 41,9%; р<0,0001), которое сменялось снижением уровня НТЖ при восстановлении кроветворения (89,5% против 96,8%; р=0,003). Одновременно установлено изменение активности антиоксидантных ферментов. Активность каталазы была повышенной в течение всего периода цитопении (3,8 и 3,3 усл. ед. акт/мл против 5,7 усл. ед. акт/мл; р=0,028 и р=0,011). Снижение активности СОД (21,0 усл. ед. акт/мл против 41,0 усл. ед. акт/мл; р=0,018) и повышение активности ЦП (1,1 г/л против 0,8 г/л) выявлены в период увеличения количества лейкоцитов до ≥1·109/л. Заключение. После окончания интенсивной цитостатической терапии развивается фазовое повышение НТЖ, сопровождаемое компенсаторным изменением активности АОС, которое направлено на нейтрализацию продуктов СРО.
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