The effects of high dose methylprednisolone on apoptosis in children with acute lymphoblastic leukemia

Uckan D., Yetgin S. , Cetin M., Ozyurek E., Okur H., Aslan D., ...More

CLINICAL AND LABORATORY HAEMATOLOGY, vol.25, no.1, pp.35-40, 2003 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 25 Issue: 1
  • Publication Date: 2003
  • Doi Number: 10.1046/j.1365-2257.2003.00475.x
  • Page Numbers: pp.35-40


Rapid leukemic cell kill at initial diagnosis of patients with acute lymphoblastic leukemia (ALL) has been shown to be associated with a favorable outcome. The aim of the present study was to investigate the effect of high dose methylprednisolone (HDMP) on in vivo blast cell apoptosis in children with ALL. Annexin V-binding and Fas (CD95), Fas ligand (FasL; CD95L), and Bcl-2 expression in PB blasts were determined in newly diagnosed children with ALL before and 4, 24, 96 h after initiation of HDMP treatment (n = 20) or conventional dose steroids (CDS) (n = 10) as the control group. A decrease in absolute blast count (from 40.8 x 0(9) to 21.4 x 10(9) /l) associated with an increase in apoptosis (14.2 to 26.9%) (P < 0.05) was detected 4 h after initiation of HDMP. A significant increase in Fas and FasL expression was detected 96 h after HDMP. There was no significant change in apoptosis, Fas and FasL expression from baseline in the control group treated with CDS. The changes in Bcl-2 expression after treatment was not significant in both groups. The results of this preliminary study have shown that HDMP treatment was effective in inducing immediate (within 4 h) blast cell apoptosis. The contribution of Fas/FasL interaction in the rapid component of cell kill remains to be determined, as the increase in the expression of these molecules was evident later.