Expression And Clinical Significance Of Vascular Endothelial Growth Factor In Patients With Acute Leukemia

[Objective] To determine the levels of vascular endothelial growth factor (VEGF) in serum and cultural supernatant of bone marrow mononuclear cell (CSBMMNC) from patients with acute leukemia(AL) and its clinical significance. [Methods]The levels of VEGF in serum and CSBMMNC were measured by sandwich enzyme-linked immunosorbent assay(ELISA) method in 71 patients with AL which concluded 31 patients with acute lymphocyte leukemia(ALL) and 40 patients with acute non-lymphocyte leukemia(ANLL) and 20 normal-control subjects.Give 2 cycles of conventional chemotherapy to the newly diagnosed patients with AL and analysis the relationship of the change of VEGF and the response to treatment. [Results] 1. In newly diagnosed patients with AL, the differences in the serum and CSBMMNC levels of VEGF between the ANLL group and the ALL group were not significant (both P>0.05),but the serum and CSBMMNC levels of VEGF were significantly higher than those of the normal-control subjects.(both P<0.01).2. In complete remission(CR) patients with AL, the differences in the serum and CSBMMNC levels of VEGF between the ANLL group and the ALL group were not significant (both P>0.05),but the serum VEGF levels in the two groups were significantly higher than the normal-control subjects.(both P<0.01).The difference in the CSBMMNC VEGF levels between the two groups and the normal-control subjects was not significant(P>0.05).3. The differences in the serum and CSBMMNC levels of VEGF between newly diagnosed patients and CR patients with AL were significant (both P<0.01). 4. The differences in the serum and CSBMMNC levels of VEGF between newly diagnosed patients and relapsing/refractory patients were not significant (both P>0.05) ;The differences in the serum and CSBMMNC levels of VEGF between relapsing/refractory patients and CR patients were significant (both P<0.01) , the same as relapsing/refractory patients and normal-control subjects. 5. The serum and CSBMMNC levels of VEGF in newly diagnosed patients with AL were irrelevant to sex,age ,the count of white cells,red cells ,platelet and the Hemoglobin levels in peripheral blood. The serum and CSBMMNC levels of VEGF were markedly correlated with the count of blast cells in bone marrow (the r value were 0.521 and 0.849 respectively,both P<0.01); but for the CR patients the opposite was true. (the r value were 0.120 and 0.030 respectively,both P>0.05).6. After 2 cycles of conventional chemotherapy, the 33 newly diagnosed patients with AL were divided into 2 groups according to the antetreatment serum and CSBMMNC levels of VEGF, that is, by the medians 729.31ng/L,791.51ng/L as the dividing line. There were 4 CR and 7 non-CR of 11 AL patients with the serum VEGF levels above the median(The CR rate was 36.36%);there were 20 CR and 2 non-CR of 22 AL patients with the serum VEGF levels below the median (The CR rate was 90.90%).The CR rates in two groups were significantly different(P<0.01)。There were 5 CR of 12 AL patients with the CSBMMNC VEGF levels above the median (The CR rate was 41.67%);there were 19 CR of 21 AL patients with the CSBMMNC VEGF levels below the median (The CR rate was 90.48%). The CR rates in two groups were significantly different(P<0.01)。The CR rate in the group of high levels of VEGF was lower than that in the group of low levels. It provided that the levels of VEGF in antetreatment predicted the response to chemotherapy.7. The 33 newly diagnosed patients with AL were divided into two groups by the response to treatment. After 2 cycles of conventional chemotherapy the patients who obtained CR belonged to the clinical sensitive group in these patients. The others belonged to the clinical resistant group. The serum average VEGF levels in the clinical resistant group were obviously higher than those in the clinical sensitive group. The values were 953.70±170.56ng/L and 674.50±386.58ng/L respectively, which were significantly different(P<0.01); The CSBMMNC average VEGF levels in the clinical resistant group were much higher than those in the clinical sensitive group. The values were 1060.84±224.79ng/L and 709.31±362.24ng/L respectively, which were also significantly different(P<0.01).The levels of VEGF in the clinical resistant group were higher than those in the clinical sensitive group ,it was quite possible that the serum and CSBMMNC levels of VEGF in newly diagnosed patients with AL bore some relation to the sensitive of patients in chemotherapy. [Conclusion] 1. The patients both in the ANLL group and the ALL group had the exceptional expression of VEGF, the levels of VEGF in the two groups had no significantly different. It indicated the levels of VEGF and angiogenesis probably played a key role in the pathogenesis of AL, which provided a basis for the development of the biological target therapy of anti-neovascularization in leukemia. 2.The increase of the serum and CSBMMNC levels of VEGF in newly diagnosed patients and relapsing/refractory patients with AL was related to the growth and multiplication of leukemia cell. 3. The levels of VEGF in serum and CSBMMNC in newly diagnosed patients with AL were related to the recent response to chemotherapy. 4. The levels of VEGF in serum and CSBMMNC in newly diagnosed patients with AL were closely related to the clinical condition change.The CSBMMNC VEGF levels in CR patients fell to normal. So dynamically testing the change of serum and CSBMMNC levels of VEGF may help to get a good knowledge of the quantity of leukemia cell and the status of patients in certain degree. The levels of VEGF can be used as a guide to the assistance index of the response to treatment and the prognosis judgment of acute leukemia. 5. The method to measure the levels of VEGF in serum and CSBMMNC by sandwich enzyme-linked immunosorbent assay(ELISA),which have many merits that included simple ,convenience ,reliability ,hypersensitivity,practice and etc.