Preliminary Study On The Dynamic Changes Of Anti-mullerian Hormone And Inhibin B Of Prepubertal Acute Lymphoblastic Leukemia Girls At The Stage Of Initial Chemotherapy

Objective:The objective is to know the dynamic changes of AMH and INHB of prepubertal ALL girls at the stage of initial chemotherapy and to discuss the influence of CCCG-ALL-2015 on ovarian function.Methods:We chose 21 girls who received chemotherapy in the department of hematology in our hospital for the first onset standard-risk acute lymphoblastic leukemia.They were selected from July 2015 to February 2016.All of them were prepubertal girls.The age was3.91±1.96 years old(from 1.8 to 8.5 years old) on the initial diagnosis. They all received the CCCG-ALL-2015 chemotherapy regimens.During the course of chemotherapy, determined the levels of AMH and INHB at the stages of pre-chemotherapy,after three months and six months of chemotherapy by ELISA. Then we compared the dynamic changes of AMH with the paired samples T test. We compared the dynamic changes of INHB with the Wilcoxon Matched-Pairs Signed-Ranks Test.Results:We followed 21 ALL girls in this experiment. The age of onset was 3.91±1.96 years old(from 1.8 to 8.5 years old). All of them were the first onset standard-risk acute lymphoblastic leukemia patients.54 serum specimens were selected during the course of chemotherapy. 21 specimens were selected at the stages of pre-chemotherapy. 21 specimens were selected after three months of chemotherapy. 12 specimens were selected after six months of chemotherapy. We tested the AMH and INHB level in all these samples.The paired samples T test was adopted to evaluate the level of AMH. The results showed that the level of AMH after three months of chemotherapy were statistically significantlower than pre-chemotherapy(p=0.023<0.05). The level of AMH after six months of chemotherapy were statistically significant lower than pre-chemotherapy(p=0.045<0.05).The AMH level was no significant difference between after three months group and six months group of chemotherapy(p=0.388>0.05).At the same time, all of smples were determined the level of INHB.The results shows that the level of INHB of 12 patients were beyond the detection limit before and after Chemotherapy. Based on the Wilcoxon Matched-Pairs Signed-Ranks Test, we compared the change of INHB level between pre-chemotherapy and chemotherapy for 3 months; the change of INHB level between pre-therapy and chemotherapy for 6 months; and the change of INHB level between chemotherapy for 3 months and chemotherapy for 6months, P values respectively were 0.594, 0.225 and 0.285. There was no statistical difference between any two groups.Conclusion:1、At the initial Stage of CCCG-ALL-2015, the AMH of the girls show significant decrease and the ovarian function is disturbed.2、For prepubertal ALL girls who receive chemotherapy, AMH can be considered as an indicators to evaluate the effect of the initial chemotherapy to ovarian function.3、For prepubertal ALL girls who receive chemotherapy, INHB may not be suitable to choose as an indicator to evaluate the effect of the initial chemotherapy to ovarian function.