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. |
