تقييم مستوى عامل نخر الورم ألفا في مرضى ابيضاض الدم النخاعي الحاد في الموصل

BACKGROUND: Acute myeloid leukemia (AML) is an abnormal clonal proliferation of early hematopoietic precursor cells leading to maturation arrest and accumulation of immature myeloid cells in the bone marrow, blood, and other tissues. Bone marrow microenvironment plays a crucial role in supporting hematopoiesis, illness progression, and response to chemotherapy. Tumor necrosis factor -α is one of these microenvironments with a pleiotropic action.
OBJECTIVE: Evaluate the level of tumor necrosis factor-α in patients with AML and study its relation to other clinical prognostic factors and laboratory parameters.
METHODS: This study is a prospective case series study conducted on 40 recently diagnosed AML patients from May 2023 to October 2023. The patients were collected from the hematology units of Ibn Sina and Ibn Al-Atheer Teaching Hospitals in Mosul City, Iraq. Verbal consent was obtained for each patient, and a questionnaire was administered; blood samples and laboratory investigations were also conducted.
RESULTS: Out of 40 patients, 24 males and 16 females were between 5 and 82 years old. The serum TNF-α level of patients at presentation was much higher than that in the control group (p-value 0.000), with a significant positive relation with the marrow blast percent (p-value 0.002). The relation between TNF- α and age, neutrophils, and LDH (Lactate Dehydrogenase) level are negative and non-significant; the relation between TNF- α mean and the disease outcome is significant, with a higher level in the dead group, near the normal control level in patients went to complete remission and in between in relapse group.
CONCLUSION: A high level of TNF- α is a bad prognostic factor as it is associated with high blast count and high mortality rate secondary to high disease-related complications.