الفهرس 
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Abstract
Acute myeloid leukemia (AML) is the most common type of leukemia in adults with the lowest survival rate of all the leukemias. It is a heterogeneous disease in which a variety of cytogenetic and molecular alterations have been identified. In the last decade, change of gene expression alters the hematopoietic cell quiescent state and subsequently plays a major role in leukemogenesis. WT1 is prone to be a major player in acute myeloid leukemia and recent advances in the field of molecular biology and tumor immunology has resulted in the identification of a large number of Tumor Associated Antigens (TAAs) and their immunogenic epitopes from various types of malignant neoplasms. Identification of TAAs may also be useful as targets for immunotherapy and molecular targeting therapy as well as the development of diagnostic tools. One of the TAAs that is expressed in various types of solid tumors and hematopoietic malignancies is Wilm’s Tumor Gene 1 (WT1) which expressed in various types of solid tumors and hematopoietic malignancies. It has a dual role in malignancy as both an oncogene and tumor suppressor.
FOXP3 has a crucial role in the development and function of CD4+CD25+ regulatory T cells (Treg) which play a critical role in the control of immune responses in various clinical settings, including autoimmune diseases, allergic disorders, infec¬tions, transplantations, and cancers. The aim of work: We evaluated the impact of overexpression of WT1and FOXP3 genes on the clinical course of adult and pediatric Egyptian AML patients.
The study include two groups, 15 healthy persons as control group and AML group 97 patients divided into two subgroups, Adults (63) patients and pediatric (34) patients, Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect expression profile of FOXP3 and WT1 genes of the 97 newly diagnosed de novo AML patients that samples were retrieved from the inpatient clinic at National Cancer Institute (NCI), Cairo University (CU) and diagnosed between June 2010 to December 2012).
The results showed that In pediatric group; WT1 was significantly expressed with high Total leukocyte count median 50X109/L (P-value =0.018). In adult group; WT1 overexpression had an adverse impact on complete remission induction, Disease-free survival and overall survival (P-value =0.02), (P-value =0.035), (P-value =0.019) respectively). FOXP3 overexpression was associated with FAB subtypes AML M0 +M1 vs. M2, M4+M5 (P-value =0.039) and the presence of hepatomegaly (P-value =0.005).
In conclusion, WT1 and FOXP3 overexpression had an adverse impact on clinical presentation, treatment response and survival of pediatric and adult Egyptian AML patients.
Keywords: AML, FOXP3, WT1, qRT-PCR.