Cytokine profiling as a prognostic markers in chronic myeloid leukemia patients

Chronic myeloid leukemia (CML) accounts for 20% of all adult leukemias worldwide. Most Egyptian patients are diagnosed in the chronic phase and progress to the accelerated or blastic phase, which is related with decreased survival. Various pro-inflammatory cytokines are involved in the pathogenesis of chronic leukemia but their prognostic significance is unknown. The aim of the current study is to determine the validity of TNF-alpha, IL-6, IL-18 and CRP levels as prognostic markers in CML patients. These parameters were monitored with clinical routine tests in 25 CML patients besides ten healthy control subjects at National Cancer Institute, Cairo, Egypt. IL-6 and IL-18 levels before hydroxyurea treatment were significantly higher in all patients compared to controls (P<0.001 for both levels). At hematological remission, significant reductions were observed for IL-6 (P<0.001), IL-18 (P<0.001) and CRP (P<0.001) whereas reduction in the levels of TNF were non-significant. Moreover, an inverse correlation was observed between both of TNF (P<0.05) and CRP (p<0.01) on one side and megakaryocytic dysplasia on the other side. These findings offer evidence that TNF may have potential prognostic role in megakaryocytic dysplasia detection.