Evaluation of the Caspase-3, Calpain-2, GSH, and MDA in AML and ALL Patients Undergoing Chemotherapy

Background: leukemia is one of the most common and dangerous types of cancer around the world. The exact mechanisms that lead to leukemia development are still unknown. However, this study evaluates the biochemical dynamics of caspase-3, calpain-2, malondialdehyde (MDA), and reduced glutathione (GSH) in patients with acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) during three treatment stages: pre-chemotherapy, during chemotherapy, and post-chemotherapy.
Materials and methods: A total of 270 blood samples were analyzed, divided equally among AML, ALL, and healthy controls. Sample collection during the period continued from July 2022 to June 2024 from Medical City and Al-Kadhimain Medical City and Al-Amal National Hospital for Cancer Management in Baghdad province.
Results: We observed significant alterations in apoptotic markers (Caspase-3 and Calpain-2), oxidative stress (MDA), and antioxidant defenses (GSH). Both AML and ALL patients exhibited elevated Caspase-3 and Calpain-2 levels pre-treatment, which declined progressively during and post-treatment. MDA levels were elevated across all stages, peaking pre-treatment, while GSH levels were significantly reduced. Comparative analysis revealed distinct biochemical profiles between AML and ALL patients, with AML exhibiting higher apoptotic activity. Correlation analyses highlighted complex interplays between apoptosis, oxidative stress, and antioxidant responses.
Conclusion: These findings confirm the potential of Caspase-3, Calpain-2, MDA, and GSH as biomarkers for monitoring therapeutic efficacy and managing the leukemia treatment protocols.