Plasminogen Activator Inhibitor-1 and Vitronectin Levels in Children with Acute Lymphoblastic Leukemia, and Their Relationship with Risk Groups

Abstract 4365

Fibrinolytic system plays a role in tumor growth, invasion and metastasis in cancer. High levels of plasminogen activator inhibitor-1 (PAI-1) which is a part of fibrinolytic system is a sign of poor prognosis in a number of cancer types. Acute lymphoblastic leukemia (ALL) is the most frequent malignant disease of childhood. Risk groups of ALL are used to determine treatment strategies in childhood ALL. In this study, we aimed to ascertain the prognostic and predictive roles of PAI-1 and vitronectin in children with ALL, and their relationship with risk groups of ALL. In the literature, there are few studies with PAI-1, but no study with vitronectin and ALL in children. In this study, we analyzed the plasma PAI-1 and vitronectin levels of 37 recently diagnosed ALL patients (age range: 9 months–17 years), and 25 age-matched healthy children as a control group by using the ELISA technique. The mean PAI-1 levels was 27.36±16.53 ng/ml, vitronectin levels 97.54±29.82% in the ALL group; and, 23.60±10.44 ng/ml, 85.50±20.85% in the control group, respectively. It was found that the plasma vitronectin levels of ALL group was high as nearly statistically significant (p=0.06). Although, the PAI-1 levels of ALL group was higher than the control group, there was no statistically significance (p=0.27). The ALL group was divided into three risk groups (standard, moderate, and high) according to the BFM protocol. When the standard and moderate-high risk groups are compared with control group, the vitronectin levels of standard risk group was higher than the control group (p=0.048), but no difference was found for PAI-1 levels (p=1.00). There was no significant difference for vitronectin levels (p=0.76), and PAI-1 levels (p=0.25) between moderate-high risk groups and the control group, although PAI-1 levels were higher in moderate-high risk groups. In conclusion, we could not find any relationship between the parameters of fibrinolytic system and ALL risk groups except the vitronectin levels of standard risk group, new studies are needed.