The impact of reproductive hormone changes on the immune response of patients with leukemia

Abstract

Background & Objective: Leukemias have been associated with various immune and endocrine changes. Several studies have established a correlation between an imbalance in pituitary hormones and sex steroids and the initiation of illness in either one or both genders. The hormone changes can affect normal physiological homogeneity of the human body, thus effecting health as well as the course of unrelated diseases. We aimed to investigate the influence of alterations in reproductive hormones on the immune response of individuals diagnosed with leukemia. Material and Methods: In this case-control study, a total of 130 subjects, out of which 80 patients were known cases with hematological cancer, were enrolled at the Medical City Department/Hematology Center in Baghdad, Iraq, from February-October 2022. Out of 80 patients diagnosed with leukemia, 45 patients had acute myeloid leukemia (AML), and 35 patients had acute lymphoblastic leukemia (ALL). The study involved 50 healthy controls. Estradiol (E2), triiodothyronine (T3), follicle-stimulating hormone (FSH), and progesterone levels were measured using both ELISA and the immunofluorescence assay method in all participants. C-reactive protein (CRP), ferritin, and neutrophil-to-lymphocyte ratio (NLR) was also determined. Results: The findings of the study demonstrated a significant elevation in the levels of CRP, ferritin (P < 0.001), and NLR (P = 0.01) in the individual’s group when compared to the control group. Serum progesterone was increased in patients diagnosed with AML and ALL in comparison to the control group (P = 0.01). FSH was elevated (P = 0.02) in AML and decreased in ALL. This difference was found to be statistically significant. The levels of T3 and E2 were found to be significantly reduced in both AML and ALL patients when compared to the control group (P = 0.1 and 0.02 respectively). Abbreviations: ACTH - Adrenocorticotropic Hormone; ALL - Acute Lymphoblastic Leukemia; AML - Acute Myeloid Leukemia; E2 – Estradiol; LH - Luteinizing Hormone NLR - Neutrophil-To-Lymphocyte Ratio Conclusions: The findings of the study offer empirical support for the impact of hormones on the immune response in leukemia pathogenesis. Key words: Leukemia; Reproductive Hormones; Immune Response Citation: Thabit JA, Almzaiel AJ, Kadhim MI, Alrufaie MA. The impact of reproductive hormone changes on the immune response of patients with leukemia. Anaesth. pain intensive care 2023;27(5):585−591; DOI: 10.35975/apic.v27i5.2317 Received: August 06, 2023; Reviewed: August 12, 2023; Accepted: August 12, 2023