Clinical Value of Stromal Cell Factor (Sdf-1) Determination in Chemotherapy-Induced Peripheral Polyneuropathy in Patients with Hematological Malignancies (Results of a Prospective Cohort Study)

Abstract

Background. Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common complications of chemotherapy for hemoblastoses in children, which, according to researchers, occurs in 30–100% of patients in the treatment of acute lymphoblastic leukemia (ALL). Reliable laboratory markers of this disease have not been established, while their use would be appropriate in patient monitoring. Aims — to establish the clinical value of determining the stromal cell factor (SDF-1, CXCL12) in the laboratory monitoring of chemotherapy-induced polyneuropathy in the treatment of ALL in children. Methods. A single-center prospective cohort non-randomized study was conducted in the period from 2019 to 2022 of patients with ALL treated with vincristine as the main treatment. Some of them developed vincristine-induced peripheral polyneuropathy as a variant of CIPN during treatment. On this basis, all patients were divided into two groups — with CIPN (main) and without peripheral polyneuropathy (comparison group). A clinical neurophysiological study was performed, as well as the determination of stromal cell factor (SDF- 1, CXCL12) in the plasma and cerebrospinal fluid (CSF) of patients at different stages of therapy. Results. In the blood plasma of children with CIPN, the content of SDF-1 did not differ from the of healthy children and the comparison group, and during chemotherapy there was a tendency to decrease its level. In the CSF of patients of the main group the concentration of SDF-1 increased at the end of induction. The clinical value of this parameter was determined, with its content in the CSF 410 pg/ml AUC = 0.75; OR = 2.200. Conclusion. One of the candidates for the role of a laboratory marker of chemotherapy-induced peripheral polyneuropathy is the chemokine SDF-1, the concentration of which in the CSF increased in patients with ALL. In this study, the clinical value of this parameter has been established, on the basis of which it can be concluded that this laboratory parameter allows the diagnosis of CIPN with moderate accuracy, and the joint determination of this factor in blood and liquor slightly increases the accuracy of diagnosis.