الفهرس 
Chronic myeloid leukemia
Imatinib (Glivec®)Only 14 pages are availabe for public view
 |  | from | 226 |  |  |
| | | from | 226 | | |
Abstract
Chronic myeloid leukemia (CML) microenvironment is responsible for
the resistance of leukemic cells to tyrosine kinase inhibitors, altered
adhesion, increased proliferation and leukemic cells growth and survival
through the secretion of many soluble molecules. This study aimed at
monitoring soluble L-selectin (sCD62L) and secreted protein acidic and rich
in cysteine (SPARC) levels in patients with chronic phase chronic myeloid
leukemia (CP-CML) and assessing the impact of imatinib on these
aforementioned parameters.
This controlled parallel clinical trial included thirty-five subjects who
were classified into two groups: group I (control group): which included ten
healthy volunteers and group II (CP-CML patients group): which included
twenty-five newly diagnosed patients with CP-CML who received imatinib
400 mg once daily. The studied parameters were sCD62L plasma levels,
SPARC serum levels, breakpoint cluster region-Abelson1% (BCR-ABL1%),
complete and differential blood count, liver and kidney functions parameters.
These parameters were assessed three times; at baseline and three and six
months after imatinib treatment. In addition, spleen size was assessed and
Sokal risk score was calculated at baseline.
At baseline, sCD62L and SPARC levels were significantly elevated
in patients with CP-CML (P = 0.001 and P = 0.001, respectively) as
compared to the healthy control group. Three months after treatment,
sCD62L level was non-significantly decreased (P = 0.079), while
surprisingly SPARC level was significantly increased (P = 0.004) as
compared to their baseline levels. Moreover, six months after treatment,
sCD62L level was significantly decreased (P = 0.001), while SPARC level was non-significantly decreased (P = 0.24) as compared to their baseline
levels. In addition, sCD62L level was positively and significantly correlated
with white blood cells (WBCs) and neutrophils counts, while SPARC level
was positively and significantly correlated with lymphocytes count at
baseline and three and six months after imatinib treatment.
The elevated levels of sCD62L and SPARC at diagnosis in patients
with CP-CML may refer to their participation in the pathogenesis of CML,
and the dynamic changes in their levels during imatinib treatment may
suppose an additional mechanism of action of imatinib by restoring normal
adhesion besides the inhibition of BCR-ABL. Furthermore, imatinib showed
a significant impact on sCD62L and SPARC levels during the treatment
period.
Clinical trial registration identifier: NCT05387330.
Keywords: Soluble L-selectin; sCD62L; SPARC; chronic myeloid
leukemia; Imatinib.