Association Between Plasma Homocysteine And Thrombophilia In Patients With Acute Leukemia

Objective: The levels of the plasma homocysteine(Hcy),antithrombin III(AT-III)and d-dimer(DD)were determined in patients with acute leukemia(AL)before and after chemotherapy,to investigate the relationship between Hcy and AT-?,DD.And to explore the significance of Hcy in AL with thrombophilia.Method: 30 patients that newly diagnosed as AL in Qinghai University Affiliated Hospital from November 2015 to February 2017,including 23 cases of acute myeloid leukemia(AML)(non-M3)and 7 cases of acute lymphoblastic leukemia(ALL).After chemotherapy,the patients were divided into two group : Complete remission group(n=20);Non complete remission group(n=10).30 healthy people were selected as control group.The levels of Hcy,AT-III and DD were detected before and after chemotherapy(recovery phase)in the AL group.Combined with the literature found that the above indicators and high tumor load may have a certain relationship,so we tested the levels of lactic dehydrogenase(LDH)before chemotherapy and blood routine test was measured for white blood cell count(WBC)at the time of treatment.The levels of Hcy,AT-? and DD were also measured in the control group.Statistical analysis was performed using SPSS21.0.Comparison of multiple groups using the one-way analysis of variance.t test was used to compare the levels of these indicators between the same group before and after chemotherapy.The correlation between each indicator was using linear correlation analysis.P values<0.05 were considered statistically significant.Result: 1.The concentration of Hcy and DD in the AL group was significantly higher than the control group,while the level of AT-? was lower than the control group.2.Before chemotherapy,The levels of Hcy and DD in NR group were higher than that in CR group,while the level of AT-? was lower than the CR group.3.After chemotherapy,the concentration of Hcy and DD in CR group were significantly lower than before chemotherapy,and AT-? was significantly higher than before,but there was no significant difference in NR group.4.There were linear correlations between Hcy and AT-III(r=-0.419,P=0.021),DD(r=0.612,P=0.000),LDH(r=0.407,P=0.025)in AL patients before chemotherapy.while there was no correlation between Hcy and WBC(r=0.340,P=0.066).Conclusion:1.In patients with Acute leukemia,the levels of Hcy,AT-? and DD turn to abnormal,and increasing the risk of thrombophilia.2.There was a linear correlation between serum Hcy and AT-?,DD,LDH in patients with AL.3.When patients who did not achieved CR after treatment,the levels of Hcy,AT-?and DD had no significant change,so we should still pay attention to prevent the occurrence of thrombophilia;while patients achieved CR,the levels of Hcy,AT-? and DD gradually returned to normal,and the risk of thrombolysis gradually reduced.