Correlation of peripheral blood IL-17 and lactate dehydrogenase with the recurrence after allogeneic hematopoietic stem cell transplantation in children with acute lymphoblastic leukemia

YANG Qing; ZHANG Yiyu; LYU Yu

doi:10.3969/j.issn.1002-7386.2025.09.013

Abstract：Objective To explore the correlation of peripheral blood interleukin-17(IL-17)and lactate dehydrogenase(LDH)with the recurrence after allogeneic hematopoietic stem cell transplantation(allo-HSCT)in children with acute lymphoblastic leukemia(ALL).Methods A retrospective study was conducted in 101 children with ALL admitted from January 2019 to December 2023.All children received allo-HSCT,and peripheral blood IL-17 and LDH were collected 24 hours after treatment.They were followed up for one year after the treatment,and the recurrent rate was recorded.Patients were then divided into the recurrence group(n=24)and non-recurrence group(n=77).The general data and laboratory indexes of the two groups were compared by univariate and multivariate Logistic regression analysis.The correlation of peripheral blood IL-17 and LDH with the recurrence after allo-HSCT in children with ALL was analyzed,and their predictive values were evaluated.Results The proportion of patients with two or more courses of induction therapy(induction courses＞1),and non-occurrence of chronic graft-versus-host disease(GVHD),and the levels of IL-17 and LDH were significantly higher in the recurrence group than those of the non-recurrence group(P＜0.05).Multivariate Logistic regression analysis showed that induction courses＞1,no-occurrence of chronic GVHD,high IL-17 levels,and high LDH levels were the influencing factors for the recurrence after allo-HSCT in ALL children(OR＞1,P＜0.05).The receiver operating characteristic(ROC)curve was drawn,showing that the area under the curve(AUC)of either peripheral blood IL-17 or LDH in predicting the recurrence of ALL after allo-HSCT was greater than 0.7,and the AUC of the combined prediction was greater than 0.8,indicating a higher value of combined prediction.The decision curve showed that within the threshold range of 0.0-0.47 and 0.5-0.53,the combined prediction of peripheral blood IL-17 and LDH levels for the recurrence of ALL after allo-HSCT was significantly better than that of a single indicator,with a maximum net benefit of 0.238.Within the high-risk threshold range of 0.0-0.55,the net benefit of the combined prediction was greater than 0,presenting a clinical significance.Conclusion Peripheral blood IL-17 and LDH levels are associated with the recurrence after allo-HSCT in children with ALL.Elevated levels of both are risk factors for the recurrence after allo-HSCT in children with ALL,and can predict the risk of recurrence.