title: Elevated asymmetric dimethylarginine in young adult survivors of childhood acute lymphoblastic leukemia: a preliminary report.
abstract: BACKGROUND
  Adult survivors of childhood malignancy are predisposed to late cardiovascular (CV) complications. Our aim was to estimate plasma levels of the endogenous nitric oxide formation inhibitor asymmetric dimethylarginine (ADMA), in long-term survivors of childhood acute lymphoblastic leukemia (ALL) treated with only chemotherapy.
  
  
  METHODS
  ADMA and its isomer symmetric dimethylarginine (SDMA) were measured in 25 former ALL patients (aged 18-28 years) who had survived without recurrent disease ≥ 5 years from completing chemotherapy without cranial irradiation, and in 20 healthy controls (aged 20-31 years).
  
  
  RESULTS
  Characteristics of the both groups were similar, except for lower high-density lipoproteins-cholesterol (HDL-C) in ALL survivors. Compared to controls, the former ALL patients exhibited significant, albeit small, rises in levels of ADMA (0.63 ± 0.09 [SD] vs. 0.57 ± 0.07 μmol/L; p=0.016), but not SDMA, with a consequently increased ADMA to SDMA ratio (1.08 ± 0.22 vs. 0.91 ± 0.16; p=0.004). The effect of former ALL on ADMA was attenuated (intergroup p=0.10 [ANCOVA]) upon adjustment for HDL-C (ADMA vs. HDL-C regression coefficient: -0.065 ± 0.030 [SEM]; p=0.03).
  
  
  CONCLUSIONS
  ADMA is elevated in adult childhood ALL survivors, which can reflect late detrimental chemotherapy effects, partially related to minor lipid profile changes. Whether these subtle ADMA elevations might herald future CV morbidity, remains to be elucidated.
authors: Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University, Cracow, Poland.
authors: Joanna
authors: J
authors: Sulicka
authors: Andrzej
authors: A
authors: Surdacki
authors: Magdalena
authors: M
authors: Strach
authors: Aleksander
authors: A
authors: Kwater
authors: Barbara
authors: B
authors: Gryglewska
authors: Magdalena
authors: M
authors: Ćwiklińska
authors: Walentyna
authors: W
authors: Balwierz
authors: Tomasz K
authors: TK
authors: Grodzicki
mesh_terms: D000293:Adolescent; D000328:Adult; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D002318:Cardiovascular Diseases / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood* / Q000453:epidemiology; D012307:Risk Factors; D017741:Survivors
chemical_list: C018524:N,N-dimethylarginine; D001120:Arginine