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-α) 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-α 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-α (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.