ISSN: 1300-7777 E-ISSN: 1308-5263
Evaluation of Insulin-like Growth Factor-1 and Insulin-like Growth Factor Binding Protein-3 Expression Levels in Patients with Chronic Lymphocytic Leukemia [Turk J Hematol]
Turk J Hematol. 2016; 33(4): 335-338 | DOI: 10.4274/tjh.2016.0075  

Evaluation of Insulin-like Growth Factor-1 and Insulin-like Growth Factor Binding Protein-3 Expression Levels in Patients with Chronic Lymphocytic Leukemia

Mesut Ayer1, Abdullah Sakin2, Selim Ay3, Aylin Ayer3, Elif Gökçen Sazak4, Melih Aktan4
1Haseki Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
2Okmeydanı Training and Research Hospital, Clinic of Internal Medicine, Oncology Unit, İstanbul, Turkey
3Haseki Training and Research Hospital, Clinic of Internal Medicine, İstanbul, Turkey
4İstanbul University İstanbul Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey

Objective: Chronic lymphocytic leukemia (CLL) is a disease of nonproliferating and mature-appearing B lymphocytes. Insulin-like growth factor-1 (IGF-1) is a small peptide hormone and has mitogenic and antiapoptotic effects, and insulin-like growth factor binding protein-3 (IGFBP-3) has antiproliferative effects on cells. In this study, we investigated plasma levels of both IGF-1 and IGFBP-3 in patients with CLL compared with controls, and we compared these plasma levels according to prognostic factors. Materials and Methods: Patients with newly diagnosed CLL who were being followed at the Haseki Training and Research Hospital, İstanbul, Turkey, and volunteers were included in this study. Patients were stratified according to the Rai staging system. Statistical analysis was conducted using SPSS 17.0 for Windows. Results: Forty-three patients [16 women (37%) and 27 men (63%)] were enrolled in this study. Twenty-one volunteers (11 women, 10 men) were included in the control group. The median age of the patients was 65±9 years (range: 18-63 years), and subjects in the control group were 68±8 years old (range: 18-63 years). Even though the plasma levels of IGF-1 were higher and those of IGFBP-3 were lower and the ratio of IGF-I/IGFBP-3 was higher in comparison with the control group, these differences were not statistically significant (p>0.05). In the study group, IGF-1 levels appeared to be increased in parallel to more advanced Rai stages. There were no significant differences between the other groups (p=0.105). Conclusion: Plasma IGF-I levels were found higher in patients than in the control group and plasma IGFBP-3 levels were lower; however, neither result was statistically significant. Plasma IGF level increment was observed in concordance with Rai staging. These results prompted us to think that plasma IGF-1 levels in CLL patients are correlated with tumor burden and Rai staging and therefore could be a valuable prognostic factor. Further comprehensive studies are required to support our results.

Keywords: Chronic lymphocytic leukemia, Insulin-like growth factor-1, Insulin-like growth factor binding protein-


Kronik Lenfositik Lösemi Hastalarında İnsülin-benzeri Büyüme Faktörü-1 ve İnsülin-benzeri Büyüme Faktörü Bağlayıcı Protein-3 Düzeylerinin Değerlendirilmesi

Mesut Ayer1, Abdullah Sakin2, Selim Ay3, Aylin Ayer3, Elif Gökçen Sazak4, Melih Aktan4
1Haseki Training and Research Hospital, Clinic of Hematology, İstanbul, Turkey
2Okmeydanı Training and Research Hospital, Clinic of Internal Medicine, Oncology Unit, İstanbul, Turkey
3Haseki Training and Research Hospital, Clinic of Internal Medicine, İstanbul, Turkey
4İstanbul University İstanbul Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey

Amaç: Kronik lenfositik lösemi (KLL) olgun görünümlü B lenfositlerin hastalığıdır. İnsülin-benzeri büyüme faktörü-1 (IGF-1), mitojenik ve antiapoptotik etkili küçük peptid hormondur ve insülin-benzeri büyüme faktörü bağlayıcı protein-3 (IGFBP-3) ise hücre üzerinde antiproliferative etki gösterir. Çalışmamızda, KLL hasta grubu ve kontrol grubunda plazma IGF-1 ve IGFBP-3 düzeylerini ve prognostik faktörlerle ilişkisini karşılaştırdık.
Gereç ve Yöntemler: Haseki Eğitim ve Araştırma Hastanesi, Hematoloji Bölümü’nde takip edilen yeni tanı almış KLL hastaları ile kontrol grubu çalışmaya dahil edilmiştir. Hastalar Rai sistemine göre evrelendirilmiştir. İstatistiksel analiz SPSS for Windows version 17.0 kullanılarak yapılmıştır.
Bulgular: Kırk üç hasta [16 kadın (%37) ve 27 erkek (%63)] çalışmaya alınmıştır. Kontrol grubu 21 kişiden (11 kadın, 10 erkek) oluşmuştur. Hasta grubunda ortanca yaş 65±9 (18-63), kontrol grubunda 68±8’dir (18-63). Kontrol grubu ile karşılaştırıldığında; çalışma grubunda plazma IGF-1 düzeyi yüksek; IGFBP-3 düzeyi düşük, IGF-I/IGFBP-3 oranı ise yüksek olarak bulunmasına rağmen istatistiksel yönden anlamlı değildi (p>0,05). Çalışma grubunda plazma IGF-1 düzeyi yüksekliği ile Rai ileri evresi paralellik gösteriyordu. Diğer gruplarla istatistiksel yönden anlamlı farklılık yoktu (p=0,105).
Sonuç: Çalışma grubunda, plazma IGF-1 düzeyi kontrol grubundan daha yüksek, IGFBP-3 düzeyi ise düşük bulundu, bununla beraber istatistiksel yönden anlamlı farklılık yoktu. Plazma IGF-1 düzeyi yüksekliği ile Rai ileri evresi uyumlu idi. Bu sonuçlar bize, IGF-1 düzeyinin KLL hastalarında tümor yükü ve Rai evresi ile ilişkili olduğunu ve prognostik faktör olarak değerli olabileceğini düşündürmüştür. Bu sonuçları destekleyebilmek için daha geniş kapsamlı çalışmalara ihtiyaç vardır.

Anahtar Kelimeler: Kronik lenfositik lösemi, İnsülin-benzeri büyüme faktörü-1, insülin benzeri büyüme faktörü bağlayıcı protein-3


Mesut Ayer, Abdullah Sakin, Selim Ay, Aylin Ayer, Elif Gökçen Sazak, Melih Aktan. Evaluation of Insulin-like Growth Factor-1 and Insulin-like Growth Factor Binding Protein-3 Expression Levels in Patients with Chronic Lymphocytic Leukemia. Turk J Hematol. 2016; 33(4): 335-338

Corresponding Author: Mesut Ayer, Türkiye


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