Differential effect of corticosteroids on serum cystatin C in thrombocytopenic purpura and leukemia.
The aim of our study was to evaluate the influence of steroid therapy on serum cystatin C (cysC) concentrations in patients with acute lymphoblastic leukemia (ALL) and idiopthiás thrombocytopenias purpura (ITP). We studied 17 patients with ITP (girls: boys =5:12, mean age: 7.6 yrs, range between 1 to 17 years) and 18 patients with ALL (girls: boys =6:12, mean age: 6.3 yrs, range between 2 to 17 years). CysC and white blood cell count (WBC) in both group of patients were determined before and after 300 mg/m(2) cumulative dose of steroid therapy. Corticosteroids increased the level of cysC in both groups of patients, however significant increase was found only in ITP patients between pre- and posttreatment values (0.96 +/-0.27 mg/L vs. 1.16 +/- 0.3 mg/L, p =0,02). Pretreatment cysC concentrations were within the reference range in patients with ITP but not with ALL and were significantly higher in ALL patients, than in ITP patients (1.23 +/- 1,12 mg/L vs. 0.96 +/- 0.27 mg/L, p =0,02). Pretreatment WBC of ALL patients were significantly higher than of ITP patients (22.58 G/L, min. 3.5 G/L, max. 102.1 G/L vs. 7.46 G/L, min. 4.8 G/L, max. 12.3 G/L, p =0.03). We have found significant correlation between pretreatment cysC and WBC values in ALL patients (p = 0.04). Although the concentration of cysC may be slightly and reversibly influenced by corticosteroid treatment, cysC is sensitive to detect early and moderate deterioration of GFR in children with cancer.
Bardi
Edit
E
Departments of Pediatric Hematology and Oncology, University of Debrecen, Debrecen, Hungary. editbardi@hotmail.com
Dobos
Eva
E
Kappelmayer
János
J
Kiss
Csongor
C
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D055316:Cystatin C / Q000097:blood*; D005260:Female; D006801:Humans; D007223:Infant; D007668:Kidney / Q000187:drug effects; D007677:Kidney Function Tests / Q000379:methods; D007958:Leukocyte Count; D007962:Leukocytes / Q000187:drug effects; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000188:drug therapy*; D011696:Purpura, Thrombocytopenic / Q000097:blood / Q000188:drug therapy*
D000305:Adrenal Cortex Hormones; D055316:Cystatin C