الفهرس 
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Abstract
SUMMARY
M
ultiple myeloma (MM) is a hematological malignancy ,which is identified by the infiltration and clonal proliferation of antibody-secreting post-germinal center plasma cells in the bone marrow that lead to renal insufficiency, bone disease and anemia
Interleukin 10 (IL-10) is a cytokine with potent anti-inflammatory properties that plays a central role in limiting host immune response to pathogens. Dysregulation of IL-10 is associated with enhanced immunopathology in response to infection as well as increased risk for development of many autoimmune diseases and malignanc.
The aim of this work is to detect the presence of single nucleotide polymorphisms of IL-10 gene promotor in multiple myeloma (MM) patients using real time reverse transcriptase polymerase chain reaction (RT-PCR) technique technique aiming to study there effect on clinical features and laboratory findings at diagnosis and disease progression.
The present study included 50 MM patients compared to 50 age and sex matched healthy individuals with normal laboratory findings as a control group for analysis of single nucleotide polymorphisms of IL-10 gene promoter (rs1800872), and IL-10RB (rs2834167) genotypes by Real time- Polymerase Chain reaction (RT-PCR) technique.
In the current study, Genotypes frequency of IL-10 SNP (rs1800872), there was statistically significant difference between MM patient and the control groups (P- value 0.003) but not found as regard IL-10 RB (P –value 0.142).
There was statistical significance difference between IL-10 and its receptor B polymorphisms as regarding median hemoglobin level, calcium level, M protein level, B2 microglobulin and plasma cells as (p- value <0.005).
We found a statistical significance difference between IL-10 and its receptor B polymorphisms as regarding bone lesions as (P-value <0.001).
There was a highly statistical significant difference between IL-10 and its receptor B polymorphisms as regarding ISS as P-value <0.001.
We didn’t find any statistical significance difference between IL-10 and its receptor B polymorphisms and IG subtype, creatinine level or albumin level p-value >0.05.
Comparing the frequency of different genotypes of IL10 and IL10RB with clinical and laboratory data after management of MM patients; there was a statistical significant difference between the IL10 and IL10 RB genotypes in M protein level, plasma cells and bone lesions (P-value=0.05).
There was a statistical significant difference between the CC genotype and CA genotype of IL10 SNP and the number of patients undergo bone marrow transplantation as P-value =0.038 but not in IL10RB genotypes (p -value=0.571).
Regarding follow up of patients after therapy there was statistical significant difference between the CC genotype and CA genotype of IL10 SNP regarding complete remission as P-value =0.046. According to IL10 RB genotypes; there was highly statistical significant difference between the (GG –GA) and AA as P-value < 0.001.
There was no statistical significant difference in follow up regarding overall survival in relation to IL10 SNP genotypes MM patients (p-value= 0.472) but there was highly statistical significant difference in IL10RB SNP genotypes MM patients (p-value < 0.001).
There was a highly statistical significant difference in follow up regarding DFS and EFS in relation to IL10RB SNP genotypes MM patients (p-value < 0.001) but no statistical significant difference in relation to IL10 SNP genotypes MM patients as DES (p-value = 0.713) and EFS (p-value = 0.603).
In conclusion, our study demonstrated that IL-10 and its receptor B polymorphisms are associated with MM and clinicopathological features as high ISS stage and bad response to chemotherapy. IL-10 has a significant role in the pathogenesis and development of this disease. IL-10RB polymorphisms are associated with bad OS, DFS and EFS .So IL-10 and its receptor B polymorphisms may be a valuable new marker in the diagnosis and prognosis of MM patients. Therefore, measurement of serum IL-10 might be helpful for predicting stage and clinical management of MM.