Prognostic significance of survivin and tumor necrosis factor-alpha in adult acute lymphoblastic leukemia

Objectives: Acute lymphoblastic leukemia (ALL) is an aggressive cancer especially in adults as only 20-40% are cured with current treatment regimens. Design and methods: We measured survivin and tumor necrosis factor-alpha (TNF-alpha) in serum of 30 ALL patients before and after induction therapy and compared to 30 age and sex matched normal adults. Results: Survivin at cutoff value 15.18 pg/mL was detected in all ALL patients before therapy but in only 83.33% after therapy and not detected in the control group; P < 0.001. However TNF-alpha at cutoff value 60.05 pg/mL was detected in 90% ALL patients before therapy and 86.6% after therapy that was significantly higher than the control group (20%); P < 0.001. Survivin showed a significant positive correlation with TNF-alpha. (P < 0.05), bone marrow blast cells (P < 0.01), peripheral blast cells (P < 0.05) and Philadelphia chromosome (P < 0.01). Conclusions: Survivin may have an important role in the development of acute leukemia and it could serve as a significant prognostic marker. (C) 2011 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.