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Quantification of Plasma and Bone Marrow VEGF and Angiopoietin-2 Levels in Pediatric Malignancies

Hintsala, Emilia BSc; Bono, Petri MD; Andersson, Sture MD; Kivivuori, Sanna-Maria MD

Journal of Pediatric Hematology/Oncology: October 2012 - Volume 34 - Issue 7 - p 503–510
doi: 10.1097/MPH.0b013e318257f2a8
Original Articles

Introduction: Data on angiogenesis in pediatric patients with malignancy are scarce. Our aim was to study angiogenic growth factors vascular endothelial growth factor (VEGF) and angiopoietin-2 (Ang2) in pediatric oncological patients at diagnosis and a few months after the beginning of the therapy.

Patients and Methods: Eighty-four consecutive patients with malignancy were included in this study. The levels of plasma and bone marrow VEGF and Ang2 were analyzed by enzyme-linked immunosorbent assay.

Results: The levels of VEGF were higher in patients with solid tumors than in patients with leukemias (P=0.003), whereas Ang2 concentrations showed the opposite (P=0.003). Interestingly, the plasma concentrations of both VEGF and Ang2 correlated with concentrations in the bone marrow (P<0.05). Leukemia patients with lower VEGF level and patients with higher Ang2 level at follow-up had longer event-free survival than other patients (P=0.032 and 0.053, respectively).

Discussion: The results of our study enlighten the behavior of 2 different angiogenic factors in pediatric patients with malignancy. An interesting finding was the connection between survival of pediatric leukemia patients and angiogenic factor levels a few months after the beginning of therapy. Pathophysiology and clinical applications of these findings need further studies.

*Division of Hematology-Oncology and Stem Cell Transplantation

Division of Neonatology, Children’s Hospital

Department of Oncology, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland

The authors declare no conflict of interest.

Reprints: Sanna-Maria Kivivuori, MD, Division of Hematology-Oncology and Stem Cell Transplantation, Children’s Hospital, University of Helsinki and Helsinki University Central Hospital, PO Box 281, 00029 Helsinki, Finland (e-mail:

Received May 25, 2011

Accepted November 15, 2011

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.