الفهرس 
Acute lymphoblastic leukemiaOnly 14 pages are availabe for public view
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Abstract
Acute lymphoblastic leukemia (ALL) is a malignant disease of the bone marrow in which early lymphoid precursors proliferate and replace the normal hematopoietic cells of the marrow.Doxorubicin is a well- established chemotherapeutic agent for treatment of childhood ALL, but its efficacy is often limited by its related cardiotoxicity. Cardioprotection against doxorubicin- induced cardiotoxicity can be of great value,especially for children. Silymarin(SM) , an extract from the Silybum marianum (milk thistle) plant, has a potent antioxidant properities that can be helpful in preventing cardiotoxicity. Aim of the study: To asses the possible protective role of silymarin against doxorubicin induced cardiotoxicity in children with acute lymphoblastic leukemia. Subjects and Methods: This study was conducted on 40 children with acute lymphoblastic leukemia,including 20 patients under doxorubicin therapy and silymarin 420mg/day for one week before starting doxorubicin and one week after each doxorubicin dose [group I ] and 20 patients under doxorubicin and placebo [group II]. They underwent conventional echo-doppler measures of left ventricular systolic and diastolic functions and pulsed wave tissue Doppler of lateral mitral annulus. Results: No significant differences in echocardiographic parameters between group I and group II before therapy were observed. There were non-significant reduction in diastolic function parameters [ E/A ratio or e/a ratio] after therapy in both Groups, but there were statistically significant reduction in systolic function parameters [EF, FS and s wave] in group II after treatment with doxorubicin more than in group I after doxorubicin and silymarin therapy. Conclusion: Silymarin decreased Doxorubicin induced cardiotoxicity and can be recommended as adjuvant drug in patients with ALL under doxorubicin therapy. Recommendation: Multicenter study on large number of patients with larger duration of follow up to prove the protective effects of silymarin in Doxorubicin induced cardiotoxicity.