الفهرس 
TNF alphaOnly 14 pages are availabe for public view
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Abstract
Abstract
Background Tumor necrosis factor (TNF) is a cytokine with pleiotropic biological activities, including the induction of programmed cell death and the regulation of immune cell proliferation and differentiation. TNF-α is a product of not only of macrophages, T-cells, B-cells and monocytes , but also produced by a wide variety of tumor cells.
Aim The aim was to assess the expression of tumor necrosis factor (TNF) alpha in the serum of adult patients with acute leukemia and its correlation with the disease outcome.
Patients and methods Serum TNF alpha was measured using enzyme-linked immunosorbent assay in 30 adult de novo acute leukemia patients. 15 newly diagnosed AML patients and 15 newly diagnosed ALL patients were chosen for the study , besides 15 age-matched and sex-matched healthy controls were included in the study. All patients were recruited from Clinical Hematology Department, Ain Shams University Hospital (Cairo, Egypt) over the period from April 2019 to April 2020 and followed for 1 year
Results Both acute leukemia groups had higher serum TNF alpha level compared with controls with statistically significant difference (P<0.001) . In addition , there was statistically significant difference in both AML and ALL groups regarding the level of TNF alpha where it was high in ALL more than AML(P=0.014). In AML patients, there was a high significant negative correlation between TNF alpha and DFS (p=0.001) , OS (p<0.001) while no statistically significant difference between TNF alpha and EFS(P=0.692).In addition, no significant correlation was found between age ,cbc parameters , LDH , BM blasts and DFS , OS and EFS except for initial Hb level where a negative correlation was detected between it and DFS(P=0.033) and OS (P=0.025). In ALL patients, a significant negative correlation was detected between TNF alpha and DFS (p<0.001) and OS (p<0.001) while no statistically significant difference between TNF alpha and EFS(P=0.804).In addition, no significant correlation was found between age ,cbc parameters , LDH , BM blasts and DFS , OS and EFS except for initial WBC level where a negative correlation was detected between it and OS(P=0.041) .ROC analysis shows that The optimal cutoff value for serum TNF alpha in predicting patient survival in patients with ALL and AML was 245 and 170 pg/ml, respectively.
Conclusion Serum TNF alpha at diagnosis can be used as a poor prognostic marker in patients with acute leukemia and can be used as a predictor for DFS, OS and EFS.