Key result
Prophylactic L-arginine during leukemia chemotherapy is linked to improved endothelial function and fewer ECG changes.
Why the study?
Does L-arginine prevent endothelial dysfunction and anthracycline cardiotoxicity in adult acute leukemia patients receiving chemotherapy?
Cohort (n=81)
Does L-arginine prevent endothelial dysfunction and anthracycline cardiotoxicity in adult acute leukemia patients receiving chemotherapy?
L-arginine administration during anthracycline chemotherapy for acute leukemia may mitigate prooxidant-antioxidant imbalance and improve endothelial function, potentially reducing cardiotoxicity.
L-arginine was associated with better endothelial function during chemotherapy; hypothesis-generating for cardiotoxicity prevention and requires RCTs before practice change.
AIM: . MATERIALS AND METHODS: A total of 81 adult AL patients (38 males and 43 females with the age of 16-59 years) were studied. The patients were divided into two groups: group I (n = 34), AL patients treated with chemotherapy (CT) and L-arginine hydrochloride; group II (n = 47) - AL patients treated with CT only. Cardiac evaluation and endothelial function assessment were performed at baseline and after second CT. Electrocardiography (ECG) parameters, lipid peroxidation activity, antioxidant protection and NO system state were evaluated. RESULTS: The bioelectric activity abnormalities of the myocardium were observed in studied patients with low cardiac risk after induction CT. In case of L-arginine administration, only minimal daily ECG changes were recorded. A significant difference in the lipid peroxidation and antioxidant defense system activity in patients of groups I and II was determined. We noticed deepening of endothelial dysfunction on the background of cytostatic therapy with anthracycline antibiotics compared with baseline values in patients of group II. It was found that prophylactic L-arginine increases superoxide dismutase level and reduces the total NOS activity due to its inducible isoform. CONCLUSION: The leading factor of anthracycline-induced cardiotoxicity is the imbalance between free radical generation and their inactivation that leads to endothelial dysfunction development. L-arginine eliminates the prooxidant-antioxidant imbalance and improves the endothelial function.
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Скрипник et al. (2017) conducted a cohort in Acute Leukemia (n=81). L-arginine hydrochloride vs. Chemotherapy only was evaluated on Endothelial function, ECG parameters, lipid peroxidation, and NO system state. Prophylactic L-arginine administration in acute leukemia patients undergoing chemotherapy improved endothelial function and minimized daily ECG changes compared to chemotherapy alone.
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