Clinical value of serum interleukin-13 levels in vincristineinduced polyneuropathy in children with acute lymphoblastic leukemia

Abstract

Vincristine polyneuropathy is the leading neurotoxic effect when treating pediatric acute lymphoblastic leukemia (ALL). Recent studies have demonstrated involvement of immune system in pathogenesis of peripheral nervous system damage. Over recent years, there have been reports examining the relationship between interleukin-13 (IL-13) and development of toxic effects of chemotherapeutic drugs. Our objective was to assess clinical value of IL-13 level in children with vincristine polyneuropathy. The study included 27 children with ALL aged from 3 to 17 years, who received chemotherapy according to the conventional protocol. Plasma IL-13 levels were determined, and the values in two subgroups have been compared taking into account development of vincristine polyneuropathy. IL-13 content was assessed by multiparametric immunofluorescent analysis with magnetic microspheres (xMAP technology, Luminex 200, USA) and using ProcartaPlex Human Cytokine/Chemokine test system (Invitrogen, USA). Vincristine polyneuropathy in the study group was registered in the majority of children (n = 15) manifesting mainly at the induction stage of chemotherapy and presenting as predominance of sensory disorders. In a comparative analysis of IL-13 plasma levels in patients with vincristine polyneuropathy, we observed a statistically significant increase of its concentration, in contrast to patients without signs of peripheral nervous system damage (p = 0.042). The diagnostic sensitivity of this index was 75%, specificity – 100%, the integral index characterizing the accuracy of the test was 0.89. IL-13 changes were found to correlate with higher relative risk level, indicating its significant relationship to the development of vincristine polyneuropathy. The results of the study on the IL-13 content in blood plasma in children with vincristine polyneuropathy allowed us to consider it a predictive biological marker of peripheral nervous system damage.

Keywords

• neurotoxicity
• acute leukemia
• children
• polyneuropathy
• chemotherapy
• interleukins