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Abstract
Adhesion molecules play an important role in cell-cell and cell –extracellular matrix interactions between hematopoietic cells and the stromal microenviroment. (Drillenburg et al., 2002). In lymphoma and ALL, the expression patterns of these molecules may alter the adhesive qualities of malignant cells influencing their proliferation, spreading, location and apoptosis of malignant cells.sCD44 sheds from the cell surface and release as soluble molecules (Angelopoulou et al., 2001). Serum sCD44 was a useful marker for reflection of disease status in leukemia and lymphoma patients and monitoring response to treatment and disease progression (Guo et al., 2001). This work was carried out to evaluate the serum level of CD44 for assessment of disease activity ,monitoring the response of treatment in lymphoma and acute Lymphoblastic Leukemic patients and also correlation of this marker with the other prognostic factors. This work was carried out on 50 subjects (35 of them were patients with leukemia and lymphoma and 15 healthy children as control). The patients were diagnosed, treated and followed up in the oncology unit of pediatric department, Zagazig University. Five groups were included in this study: group (1): Twenty case of newly diagnosed patients of ALL. group (2): Fifteen cases of newly diagnosed patients of Lymphoma composed of 10 case of Non Hodgkin lymphoma and 5 case of Hodgkin disease. group (3): The same twenty patients of ALL after induction of remission. group (4): The same fifteen patients of lymphoma after induction of remission. group (5): fifteen healthy children were taken as control group. All patients and control groups were subject to the following: (1) Full history taking and full clinical examination. (2) Routine laboratory tests including: (a) Complete blood picture. b) Liver and kidney function tests. (c) Serum lactate dehydrogenase enzyme (d) Erythrocyte sedimentation rate. (e) Bone marrow examination for patients. (f) Immunophenotyping for leukemic patients. (g) Histopathological examination for patients groups. (3) Special investigations including: Measurement of soluble CD44 in serum by ELISA technique *In this study, the results were statistically analyzed and revealed the following: •Median of CD44 is significant with hepatosplenomegaly in lymphoma patients. •Median of CD44 is non significant with hepatomegaly in ALL Patients. •Median of HB level was significantly lower in leukemia and lymphoma patients at diagnosis when compared to control. It is increased significantly at remission but still lower than control group. •Median of total leucocytes count was statistically higher in ALL and lymphoma patients at diagnosis than the value of control group, but there was no statistical significant between leukemia and lymphoma group at diagnosis. There was a highly significant decrease in T.L.C in lymphoma patients and a significant decrease in T.L.C of leukemia patients at remission when compared with those at presentation. •Median of the platelets count was statistically lower in lymphoma and leukemia patients at diagnosis than the value of control group. There was a significant increase in median of platelets count in lymphoma patients at remission compared to those at presentation but highly significant increase in median of platelets count in leukemic patients at remission compared with those at presentation. •Median of blast cells in the peripheral blood in leukemic patients at remission were a highly significant decrease compared to those at presentation. •Median of relative count of blast cells in bone marrow in leukemic patients at remission were a highly significant decrease compared to those at presentation. •Median of LDH levels were a highly significant increased in lymphoma and leukemic patients at diagnosis compared to control group and it was significantly decreased at remission compared to those at presentation. •Median of E.S.R levels were a highly significant increased in lymphoma and leukemic patients at diagnosis compared to control group, and it were significantly decreased after remission than those at presentation. •Median serum sCD44 levels were significantly higher in patients with lymphoma and acute lymphoblastic leukemia at presentation compared to the normal range of control group. There was a highly significant decreased in sCD44 level in patient at remission compared to those at presentation, but its level still higher than the control group. •There was a highly significant difference in serum level of sCD44 in relation to FAB classification i.e higher level of sCD44 in L3 than L2 and L2 than L1 either before or after induction. •There was no significant difference in serum level of sCD44 in relation to Lymphoma stages either before or after induction, although sCD44 is high in advanced stages than early stage, but within each stage there is a significant difference between each stage. •There was no significant difference between serum level of sCD44 and histopathology of Lymphoma in both NHL and HD. •There was a highly significant increase in sCD44 level in NHD patients compared to HD patients either before or after induction.•The decrease in serum level of sCD44 is parallel to the attatinement of complete response to chemotherapy in patients with Lymphoma and ALL. •High sCD44 level at the time of diagnosis and at remission was associated with poor response, and several other adverse prognostic factors.•Previous and present studies were taken together suggest that measurement of sCD44 is valuable tool to monitor treatment response in lymphoma and leukemic patients however it may not be an improved prognostic markers. Conclusion: from previous results it was concluded that, serum concentration of sCD44 may offer a rapid and non invasive measure for tumor burden and disease status in patients of ALL and lymphoma. sCD44 level might be a useful marker for monitoring response to treatment and serve as new prognostic criteria.