The importance of the blood levels of homocysteine, folic acid and vitamin B12 in children with malignant diseases.

PURPOSE Hyperhomocysteinemia is associated with carcinogenesis. Since only little research exists on hyperhomocysteinemia and malignancy in children, the possible relationship between homocysteine and childhood malignancies remains unknown. The aim of the present study was to determine the serum levels of homocysteine, folic acid and vitamin B12 in children with malignant and benign tumors prior to therapy (surgical treatment and/or chemotherapy), and after treatment of malignant diseases as well. METHODS Forty-six children with newly diagnosed malignant diseases (solid tumors and lymphoproliferative/myeloproliferative (LP/MP) malignancies) and 6 children with benign tumors were included in the present study. The patient age ranged between 2 months and 18 years. RESULTS Significantly increased homocysteine concentrations were identified in children with malignant diseases compared with those with benign tumors (p<0.01). The plasma concentration of homocysteine in children with malignant diseases decreased significantly following treatment (p<0.05). Before treatment, the concentration of folic acid in children with malignant solid tumors was significantly higher than in children with malignant LP/MP diseases (p<0.01). Following treatment, the concentration of folic acid was significantly decreased (p<0.05) in children with malignant solid tumors, while it was not significantly increased in children with malignant LP/MP diseases (p<0.05). The concentration of vitamin B12 in children with malignant diseases (solid tumors and LP/MP diseases) increased significantly following treatment (p<0.01), while it increased substantially (p<0.01) in patients with solid malignancies following treatment. CONCLUSION Homocysteine could be a marker of malignancy in children. Further research is needed to establish the importance of homocysteine, folic acid and vitamin B12 in pediatric malignant diseases.