THE MEDICAL JOURNAL OF BASRAH UNIVERSITY Imad AJ. Thanoon, MBChB, MSc, PhD, Department of Pharmacology, College of Medicine, University of Mosul, Iraq. OXIDATIVE STRESS AND IMMUNOGLOBULIN LEVELS IN PATIENTS WITH HODGKIN'S LYMPHOMA Imad A. J. Thanoon ABSTRACT Objective: To assess, oxidative stress (by measuring malondialdehyde "MDA" which reflects lipid peroxidation, and total antioxidant status "TAS"), and immunoglobulin levels (IgA, IgG, IgM) in patients with Hodgkin's lymphoma before and one month after starting cytotoxic drugs, in comparison with controls. Design: Case-control study Setting: This study was conducted in the Hospital of Nuclear Medicine and Department of Pharmacology, College of Medicine, University of Mosul. Patients and Methods: Twenty-three patients with Hodgkin’s lymphoma were included in this study together with 24 apparently healthy subjects taken as a control. Initially for both patients and control, serum MDA, TAS and immunoglobulin levels (IgA, IgG, IgM) were measured and reported one month from starting specific cytotoxic drugs for the patient groups and after one month gap period for the control using especial commercial kits from Randox company (UK), for measuring TAS and immunoglobulin levels, while measurement of MDA was done by laboratory method. Results: Before starting cytotoxic regimen, there was a highly significant rise in serum MDA concentration in patients with Hodgkin's lymphoma in comparison with control. After one month from starting cytotoxic regimen, there was a highly significant rise in serum MDA concentration and a significant reduction in TAS and serum immunoglobulin levels. By comparing the period before and after starting cytotoxic regimen in patients with lymphoma, there was a significant rise in MDA and a significant reduction in TAS and immunoglobulin levels with the exception of IgM which showed insignificant reduction. Conclusion: This study revealed a rise in the oxidative stress; to which patients with Hodgkin's lymphoma were liable to, by the effect of specific cytotoxic regimen. This is reflected by the rise in the serum level of MDA and a reduction in the TAS after cytotoxic regimen. It also indicated a reduction in immunity of such patients during cytotoxic regimen as reflected by a reduction in immunoglobulin levels. INTRODUCTION t is well recognized that reactive oxygen species (ROS) are produced in a well regulated manner to help to maintain homeostasis on the cellular level, and normal healthy tissues [1] . Also ROS are involved either directly or indirectly in aging process [2] and in various clinical disorders including cancer [3] . Oxygen free radicals have been suggested to exert their cytotoxic effects on membrane phospholipids [4] , which stimulate the process of lipid peroxidation, which is a chain of reactions providing a continuous supply of free radicals [3] and the end product of these reactions are malondialdehyde (MDA), ethane and pentane [4] . Antioxidants allow aerobic organism to withstand daily episodes of oxidative stress by counteracting the adverse effect of free radicals, which are produced by metabolic activities within the body. In addition antioxidants deal or inhibit oxidation of molecules such as carbohydrates, fat, protein and DNA [5] . Aggressive chemotherapy is the cornerstone of cancer therapy. Some reports showed that endogenous antioxidants are reduced in patients with cancer, while other showed that administration of antineoplastic agents during cancer chemotherapy results in much greater degree of oxidative stress than is induced by cancer itself [6] . Reports about immunoglobulins in patients with lymphoma before and after cytotoxic regimen are few and controversial. The aim of this study is to assess oxidant/antioxidant status and immunoglobulin levels (IgA, IgG, IgM) in patients with Hodgkin's lymphoma, before and after specific cytotoxic regimen and in comparison with controls. PATIENTS AND METHODS This study was conducted in the Hospital of Nuclear Medicine and the Department of Pharmacology, College of Medicine, University of Mosul, from Jan 2005 to Sept. 2006. Patients included in this study, should meet certain criteria for selection. Criteria for selection of cases: Diagnosis of cases of Hodgkin's lymphoma (proved by histopathology) was done by a I