الفهرس 
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Abstract
Chronic Myeloid Leukaemia (CML) is a clonal, myelo-proliferative disease that develops when a single, pluripotential, haemopoetic stem cell acquires the Philadelphia chromosome. CML was the first haematological malignancy to be associated with a specific genetic lesion. CML is often divided into three phases based on clinical characteristics and laboratory findings. In the absence of intervention, CML typically begins in the chronic phase, and over the course of several years progresses to an accelerated phase and ultimately to a blast crisis.
IL-6 is an interleukin that acts as both a pro-inflammatory cytokine and an anti-inflammatory myokine. In humans, it is encoded by the IL6 gene.IL-6 is secreted by T cells and macrophages to stimulate immune response, e.g. during infection and after trauma, especially burns or other tissue damage leading to inflammation. IL-6 also plays a role in fighting infection.
In addition, osteoblasts secrete IL-6 to stimulate osteoclast formation. Smooth muscle cells in the tunica media of many blood vessels also produce IL-6 as a pro-inflammatory cytokine.
The aim of the study was to Evaluate IL-6 as marker reflecting the efficacy of CML treatment. Also to examine the relationship of IL-6 with other prognostic factors of CML.
This study was carried on 46 CML patients; 21 males and 25 females with male : female ratio 1:1.1. Their ages ranged from 20 to 60 years with a mean age of 38.2 9.7 years. They were compared with 20 healthy volunteers;11 males and 9 females with male : female ratio 1: 0.8.Their ages ranged from17 to 52 years with a mean age 34.611.1years.
All patients were subjected to full history taking and through clinical examination, CBC and differential leucocytic count, BM aspirate /trephine biopsy, radiological investigation and ELISA for evaluation of IL-6 level. The control group underwent two of the previous panel CBC and ELISA for IL-6.
As regards IL-6 level was assayed among 46cases and 20 healthy volunteers using ELISA, there was increase in IL-6 level among studied CML patients (median 6.8, IQR 16.5) compared to control (median 4.5,IQR 1.9), and this difference was statistically significant (P=0.016). Additionally, there was increase in in IL-6 level among accelerated & newly diagnosed groups (median 57.5, IQR 204.5 & median 40.0, IQR 57.0) compared to chronic group (median 4.3, IQR 3.1) this difference was statistically significant (P =0.001 and 0.001).
There was a statistical significant association between IL-6 level and spleen size (P<0.001), as well as liver size (P=0.022) respectively.
There was also negative correlation in all patients between IL-6 and Hb value (P<0.001), IL-6 and PLT count (P=0.049).
In order to utilize IL-6 as a marker in prognosis of CML, Receiver operating characteristics (ROC) curve was used to define the best cut off value of IL-6 to discriminate between chronic phase and accelerated phase group of CML which assigned a cut off value of>13 pg/ml, with sensitivity of 100%, specificity of 96.67%, positive predictive value of 88.9%, negative predictive value of 100%and diagnostic accuracy of 99.2%.
In conclusion: the present study revealed the potential value of IL-6 to discriminate between chronic phase and accelerated phase group of CML which helps in early detection of occurrence of disease transformation, additionally confirming the role of IL-6 as a marker reflecting the efficacy of CML therapy.