Omega 3 supplementation and NF-kB levels in children with acute lymphoblastic leukemia (ALL) receiving induction phase chemotherapy

Background: NF-kB plays an important role in tumorigenesis by regulating cellular apoptosis and growth processes. Activated NF-kβ complexes were found in children with acute lymphoblastic leukemia (ALL), because it is the main regulator for lymphocyte proliferation, survival and development. Several evidence showed that omega 3 fatty acid inhibit NF-kB at any type of cancers. But the effects of omega 3 supplementation to the NF-kB level on children with ALL is still limited. Purpose: Analyse omega 3 fatty acids supplementation at NF-kB level on children with ALL receiving induction phase of chemotherapy and the outcomes of chemotherapy. Methods: an open label randomized pre- and post-test control group design clinical study, conducted at October 2014 until March 2015 at inpatient unit of Haematology Oncology ward Dr. Soetomo Distric Hospital Surabaya. Subjects were divided into 2 groups: treatment group receiving omega 3 softgel 1000 mg orally once a day at the first day of the induction phase were conducted until the last day of the induction phase; and control group. NF-kB were measured before (day 0) and after induction phase (day 42) of chemotherapy. NF-kB level were measured using Human NF-kB (Elabscience®) in ng/ml and analysed statistically using paired sample t test and independent sample t-test using SPSS ver 21 (IBM, US). Results: A total of 22 subjects were included in this study, divided into 11 as the treatment group and 11 as the control group. NF-kB level were reduced at both group; 3.10 + 4.308 ng/ml to 0.76 + 0.762 ng/ml at the treatment group and 8.20 + 11.130 ng/ml to 1.748 + SD 3.072 ng/ml. There was no significant difference of NF-kB levels before and after the induction phase after omega 3 supplementation at the treatment group (p=0.065). Conclusion: There is no significant difference of NF-kB level between the subjects receiving omega 3 supplementation and the subjects who did not had omega 3 supplementation, and there is no relationship between NF-kB levels with chemotherapy outcomes.