Modern Pediatrics. Ukraine. (2023). 4(132): 44-50. doi 10.15574/SP.2023.132.44
Makieieva N. I., Koval V. A., Gorbach T. V.
Kharkiv National Medical University, Ukraine

For citation: Makieieva NI, Koval VA, Gorbach TV. (2023). Exhaled phospholipids as a prognostic factor of pulmonary complications in children with acute lymphoblastic leukemia. Modern Pediatrics. Ukraine. 4(132): 44-50. doi 10.15574/SP.2023.132.44.
Article received: Mar 08, 2023. Accepted for publication: May 16, 2023.

Introduction. Pulmonary complications are common in children with acute lymphoblastic leukemia (ALL). The assessment of phospholipids (PL) in the exhaled breath condensate can provide more information about pathological processes in the lungs in children with ALL.
Purpose – to assess the level of PL in the exhaled breath condensate (EBC) in children with ALL and its prognostic value.
Materials and methods. 40 children with ALL aged 6-17 years were examined. 1^st group included newly diagnosed children with ALL (n=18). 2^nd group involved ALL survivors, who had completed the total course of chemotherapy (n=22). The control (С) group consisted of 15 healthy children. The levels of PL in the EBC were investigated by spectrophotometric thin-layer chromatography using an SPh 46 spectrophotometer.
Results. The frequency of pulmonary complication was 82.5% during chemotherapy protocols and 18.4% in ALL survivals. The statistically significant increase in the level of phospholipids in 1^st (150.75 (137.62; 158.45) mmol/l) and 2^nd (130.12 (120.59; 138.34) mmol/l) ALL groups compared with the group C (54.80 (48.30; 60.80) mmol/l) has been detected (p_1-C=0.0000; p_2-C=0.0000). Children of the 1^st group had significantly higher levels of PL in the EBC than children of the 2^nd group (p_1-2=0.002911). PL level in EBC collected during induction phase of chemotherapy >132.15 mmol/l can be prognostic for the development of acute pulmonary complications (Sensitivity 93.75%; Specificity 100%). PL level in EBC collected after a complete course of chemotherapy >133.28 mmol/l can be predictive for persistent pulmonary complications (Sensitivity 100.00%; Specificity 83.33%).
Conclusions. PL level in EBC can be prognostic for the development of pulmonary complications, both during chemotherapy and in long-term remission after completed chemotherapy course.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
Keywords: pulmonary complications, leukemia, children, blood-air barrier, phospholipids, surfactant, exhaled breath condensate, pneumonia.

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