摘要
Abstract
Objective To Explore the relationship between serum homocysteine(Hcy),lactate dehydrogenase(LDH)and recurrence of acute lymphoblastic leukemia(ALL)after induction chemotherapy in children Methods Using a prospective cohort study,178 children with ALL who were admitted to Henan Provincial People's Hospital from June 2021 to June 2023 were selected as the study subjects.All patients received induction chemotherapy with vincristine,daunorubicin,asparaginase,and prednisone fter one cycle of chemotherapy,the serum Hcy and LDH levels of the children were measured;Taking 2 years after chemotherapy as the follow-up observation period,the recurrence status of the children was statistically analyzed,and the relationship between serum Hcy and LDH levels and the recurrence of ALL children after induction chemotherapy was analyzed In addition,receiver operating characteristic(ROC)curves were plotted to evaluate their predictive value.Results Of the 178 children,12 were excluded,and 166 were finally included.During the 2-year follow-up,the recurrence rate among the 166 children with ALL was 27.11%(45/166).The proportions of high-risk status at initial diagnosis and minimal residual disease(MRD)on day 46(≥0.01%),as well as the serum Hcy and LDH levels,were higher in the recurrence group than in the non-recurrence group,and the differences were statistically significant(P＜0.05).Logistic regression analysis showed that serum Hcy and LDH levels were independent risk factors for recurrence in these children(P＜0.05).ROC curve shows that serum Hcy and LDH levels alone predict the AUC of relapse in ALL patients after induction chemotherapy,which are 0.795 and 0.784,respectively,while the AUC of their combined prediction was 0.893.DeLong test showed that the predictive value of the combined model was significantly higher than that of Hcy or LDH alone(P＜0.05).Conclusion The levels of serum Hcy and LDH are related to the recurrence of ALL patients after induction chemotherapy.Detecting the levels of both can predict the recurrence of ALL patients after induction chemotherapy,and the combined prediction value is higher,which is worthy of clinical application.关键词
急性淋巴细胞白血病/儿童/诱导化疗/复发/同型半胱氨酸/乳酸脱氢酶Key words
acute lymphoblastic leukemia/children/Induction chemotherapy/recurrence/homocysteine/lactate dehydrogenase
