Iftikhar -ud-Din Niazi, Shafiq Ahmed Tariq, Abid Ali


Background: Our study was based on the alteration in the Michaelis Mentin parameters Apparent
Michaelis Constant (aKm) and Apparent Maximum Velocity (aVm), which reflects activity of
actylcholinesterase (AChE). This activity decreases in Acute Lymphoblastic Leukaemia (ALL). This
decrease in aKm and aVm values shows bad prognosis. Similarly the anticancer drugs like
Daunorubicin and Doxorubicin further decreases the aKm and aVm values which worsen the
prognosis. The objective of this study was to determine and compare the extent of inhibition of
Acetylecholine Esterase by Daunorubicin and Doxorubicin in ALL. Methods: Study of 100 patients
including both male and female children who’s age ranged from 4 to 8 years and were advised
doxorubicin and daunorubicin separately were tested by Ellman’s method using acetylcholine iodide as
substrate and 5,5-dithiobis 2-nitrobenzine as a colour reagent regardless of dose regimen i.e. (once in 3
week, small dose per week or a continuous infusion for 72 to 96 hours. Results: In this study the
Michaelis Mentin parameters Apparent Michaelis Constant (aKm) and Apparent Maximum Velocity
(aVm) of the enzyme were estimated both in normal individuals and in the patients and also during
treatment with daunorubicin and doxorubicin. The value of Michaelis Mentin parameters, aKm, aVm
and percentage activity of the enzyme in normal individual are 23, 70, and 100 respectively. The values
of aKm, aVm and percentage activity of the enzyme were also estimated in the patients before and after
treatment. The values of aKm and aVm in patients of acute lymphoblastic leukaemia and percentage
activity of enzyme is decreased. After the treatment with daunorubicin and doxorubicin the values and
activity is further decreased. Conclusion: We conclude that the drugs under study both decrease the
enzyme activity but daunorubicin inhibits the enzyme more than doxorubicin.
Keywords: Doxorubicin, daunorubicin, acetylcholinestrase

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