PMID- 35547942
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 14
IP  - 5
DP  - 2022 May
TI  - Serum Tumor Necrosis Factor-Alpha Levels in Acute Leukemia and Its Prognostic 
      Significance.
PG  - e24835
LID - 10.7759/cureus.24835 [doi]
LID - e24835
AB  - Introduction Tumor necrosis factor-alpha (TNF-alpha) is a pleiotropic cytokine that 
      facilitates malignant cells in immune evasion, survival, and treatment resistance 
      by generating a favorable milieu for them. It is shown to be ectopically produced 
      by malignant/leukemic and immune cells in the tumor microenvironment, providing a 
      tumor-supportive environment and playing an important part in the establishment 
      and progression of malignant cells. It is linked to hyperleukocytosis, high blast 
      count, and poor clinical outcomes in acute leukemia (AL). Considering the varied 
      role and different expression patterns of tumor necrosis factor-alpha in acute 
      leukemia and its clinical relevance, the present study was planned to monitor the 
      level of tumor necrosis factor-alpha in patients with acute leukemia and its 
      correlation with disease outcome. The aim of this study was to monitor the level 
      of tumor necrosis factor-alpha in patients with acute leukemia at the time of 
      diagnosis and after induction chemotherapy. Material and methods The study 
      included cases classified as acute leukemia based on morphological examination, 
      bone marrow analysis, and flow cytometry. In all patients with acute leukemia (n 
      = 90) and controls (n = 10), the serum tumor necrosis factor-alpha level was 
      measured using a Diaclone Human ELISA kit (Diaclone, Besancon, France) (solid 
      phase sandwich ELISA) at diagnosis and after induction chemotherapy. Results 
      Tumor necrosis factor-alpha levels were substantially higher in T-acute 
      lymphoblastic leukemia (T-ALL) cases, followed by acute myeloid leukemia (AML) 
      and B-acute lymphoblastic leukemia (B-ALL), at the time of diagnosis, compared to 
      the control. A significant reduction in serum tumor necrosis factor-alpha level 
      was seen in patients with acute leukemia after induction phase chemotherapy (P < 
      0.05). Tumor necrosis factor-alpha levels were considerably reduced (P < 0.001) 
      in the majority of acute leukemia cases after the induction phase, while high 
      tumor necrosis factor-alpha levels were positively correlated with incomplete 
      remission status in the remaining cases. Conclusion Tumor necrosis factor-alpha 
      is involved in the progression of acute leukemia and its relapse. High levels of 
      tumor necrosis factor-alpha are linked to leukocytosis, high blast counts, and 
      worse survival in patients with acute leukemia. Monitoring of tumor necrosis 
      factor-alpha may be helpful in patients with acute leukemia in view of available 
      antitumor necrosis factor-alpha therapy.
CI  - Copyright (c) 2022, Verma et al.
FAU - Verma, Sapana
AU  - Verma S
AD  - Department of Pathology, King George's Medical University, Lucknow, IND.
FAU - Singh, Anurag
AU  - Singh A
AD  - Department of Pathology, King George's Medical University, Lucknow, IND.
FAU - Yadav, Geeta
AU  - Yadav G
AD  - Department of Pathology, King George's Medical University, Lucknow, IND.
FAU - Kushwaha, Rashmi
AU  - Kushwaha R
AD  - Department of Pathology, King George's Medical University, Lucknow, IND.
FAU - Ali, Wahid
AU  - Ali W
AD  - Department of Pathology, King George's Medical University, Lucknow, IND.
FAU - Verma, Shailendra P
AU  - Verma SP
AD  - Department of Hematology and Oncology/Clinical Hematology, King George's Medical 
      University, Lucknow, IND.
FAU - Singh, U S
AU  - Singh US
AD  - Department of Pathology, King George's Medical University, Lucknow, IND.
LA  - eng
PT  - Journal Article
DEP - 20220508
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC9090230
OTO - NOTNLM
OT  - bone marrow examination
OT  - elisa
OT  - flow cytometry
OT  - leukemia
OT  - tumor necrosis factor-alpha
COIS- The authors have declared that no competing interests exist.
EDAT- 2022/05/14 06:00
MHDA- 2022/05/14 06:01
PMCR- 2022/05/08
CRDT- 2022/05/13 11:20
PHST- 2022/05/08 00:00 [accepted]
PHST- 2022/05/13 11:20 [entrez]
PHST- 2022/05/14 06:00 [pubmed]
PHST- 2022/05/14 06:01 [medline]
PHST- 2022/05/08 00:00 [pmc-release]
AID - 10.7759/cureus.24835 [doi]
PST - epublish
SO  - Cureus. 2022 May 8;14(5):e24835. doi: 10.7759/cureus.24835. eCollection 2022 May.