APOPTOSIS MEDIATORS "S FAS AND TNF A" AS PROGNOSTIC FACTORS IN ACUTE MYELOID LEUKEMIA
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Purpose it is now widely accepted that chemotherapeutic drugs kill tumor cells primarily through the induction of apoptosis. Drug resistance can. therefore. be described as a consequence of failure of tumor cells to engage apoptosis in the presence of cytotoxic drugs. The aim of this work was to study apoptosis mediators (sFas and TNFa) as prognostic factors in AML. Patient and methods ourstudy was conducted on 45 patients with AML of recent onset (full history taking. clinical examination, complete blood count. blasts % in blood and bone Marrow. FAR subtypes. sFAS and TNFa were done for every patient before and after the end of chemotherapy by 3 weeks. Eight healthy adult persons were taken as comparison group for them serum TNFa and serum sFAS were measured The results showed that AML is more frequent with age less than 50 years (42 I 45 cases: 93.3 %) and it is slightly more in males than females. Complete remission was achieved in 51.1% of cases treated by (.3-,7 regimen). It showed significant negative correlation between presence of purpura and number of WBCs before chemotherapy with the response to chemotherapy. There was insignificant correlation between haemoglobin. platelets. blast cells in blood and bone marrow and lymphadenopathy with response to chemotherapy. Also it showed significant higher levels of TNF a and s Fas in AML than the control polio. There was significant positive correlation between fever and TNF a before chemotherapy. The presence of fever the higher TNF a. There was significant negative correlation between WBCs and TNF a and also between blast cell % in BM and sFas level before chemotherapy. There was significant correlation between FAR subtypes and INF a and sFas before chemotherapy. Non-significant correlation was present between INF a and s Fas before chemotherapy and with the response to chemotherapy. We can conclude that not all TNF a or sFas have significant correlations with age. sex. HR. WBCs. blast cells % in blood and bone marrow. FAB subtypes or with response to chemotherapy. We recommend further studies to compare the levels of TNF a. sFas and other pssible cytokines between AML patients with first presentation. relapsed or refractory presentation of AML. Again, further studies to evaluate the effects of different chemotherapeutic modalities on TNF a and sFas level are required.