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Abstract
We have analyzed the clinical significance of the plasma level of tumor necrosis-alpha (TNF-α) detection in childhood acute lymphoblastic leukemia (ALL) at diagnosis. 49 patients (pts) with B-lineage ALL (3–17 years of age) and 30 healthy children (age-related control) were enrolled in study. The mean value of the level of TNF-α was 43.4 ± 8.1 pg/ml in ALL pts and 30.7 ± 3 pg/ml in control. In ALL pts the level of TNF-α positively correlated with blast cell count in peripheral blood (R = + 0.432; P = 0.008); negatively correlated with percentages of S-phase leukemic cells (R = - 0.446; P = 0.042) and culture-induced apoptotic cells (R = - 0.41 1; P = 0.057). Pts with TNF-α level above the median value were characterized by higher WBC count (P = 0.025), lower percentage of S-phase leukemic cells (P = 0.02) and tendency to lower percentage of apoptotic cells (P = 0.07) vs pts with TNF-α level below the median value. No significant association of the level of TNF-α with treatment response at days 8 and 15 or 3-year overall survival was defined. We conclude that the elevated plasma level of TNF-α is a useful marker to assess disease activity/progression, but not prognosis of childhood B-lineage ALL.