Effect of methotrexate and doxorubicin cumulative doses on superoxide dismutase levels in childhood acute lymphoblastic leukemia

Abstract: Background Acute lymphoblastic leukemia (ALL) is the most common malignancy in children. Chemotherapeutic drugs for ALL such as methotrexate (Mtx) and doxorubicin produce reactive oxygen species (ROS), a type of free radical. The ROS can reduce levels of antioxidants in the body, including superoxide dismutase (SOD). Decreased SOD levels can cause DNA, lipid, and protein damage, which in turn may lead to adverse effects and treatment failure. Objective To determine the effect of Mtx and doxorubicin cumulative doses on SOD levels in children with ALL. Methods We conducted a retrospective cohort study in children with ALL who underwent chemotherapy in Dr. Sardjito Hospital in October 2011 who had completed the induction phase. Risk factors for decreased SOD levels were analyzed by Cox regression and hazard ratio, with a significant level of P <0.05. Results2ISDWLHQWVHQUROOHG0W[PJP2 significantly decreased SOD levels (HR 9.959; 95%CI 2.819 to 35.183; 3 +RZHYHUGR[RUXELFLQPJP2 did not significantly decrease SOD levels (HR 0.59 95%CI 0.194 to 1.765; P=0.34). Conclusion Methotrexate is associated with decreased SOD levels in children with ALL. However, doxorubicin is not associated with decreased SOD levels in the same patient population.
Keywords: acute lymphoblastic leukemia, methotrexate; doxorubicin; superoxide dismutase
Author: Khalida Fetriyani Ningsih, Sri Mulatsih, Sasmito Nugroho
Journal Code: jpkedokterangg150260

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