Background Interleukin 15 (IL-15), a proinflammatory cytokine, regulates the functions of the immune system and controls the differentiation of hematopoietic cells. However, it may also promote the development of leukemia through its role in enhancing the survival, proliferation and differentiation of leukemic precursors. Aim of the work To assess expression of IL-15 level in adult Egyptian acute leukemia patients, its correlation with disease free survival, overall survival and relapse rate, as well as its possible correlation with other prognostic parameters. Patients and methods Serum IL-15 level was measured using enzyme-linked immunosorbent assay in 30 newly diagnosed acute lymphoblastic leukemia (ALL) patients, 30 newly diagnosed acute myeloid leukemia (AML) patients and 30 age and sex-matched healthy control subjects. The patients were recruited from clinical hematology department at Ain shams university hospital over the period from April 2017 to October 2018. Results In ALL patients: The serum IL-15 level was higher in ALL patients compared to control subjects (P = 0.015). Patients with ALL with high serum IL 15 level had shorter survival compared to those with low or average serum IL 15 level (P = 0.005). In AML patients: The serum IL-15 level was higher in AML patients compared to control subjects (P = 0.010). Patients with AML with high serum IL 15 level had shorter survival compared to those with low or average serum IL 15 level (P < 0.001). Serum IL15 level has negative correlation with the date of death in patients with AML (P = 0.001). Conclusion Interleukin 15 (IL-15) is a useful poor prognostic marker in patients with newly diagnosed acute leukemia, also it can be used as a predictor for survival. Abbreviations AML (acute myeloid leukemia), ALL (acute lymphoblastic leukemia), IL-15 (Interleukin 15).

Background The term minimal residual disease (MRD) is used to describe residual disease after suboptimal induction chemotherapy, but at the same time refers to the lowest levels of disease potentially compatible with cure or to molecularly defined relapse after long term remission. This study assesses the minimal residual disease in relation to the outcome in acute myeloid leukemia patients after 6 months of treatment of chemotherapy. Aim of the work The aim of this study is assessment of measurable minimal residual disease after treatment to identify acute myeloid leukemia patients who are at high risk of poor outcome. Patients and methods Minimal Residual Disease was measured using Flow cytometry in 30 newly diagnosed a 30 newly diagnosed acute myeloid leukemia (AML) patients. The patients were recruited from clinical hematology department at Ain shams university hospital over the period from May 2017 to November 2018. Results A total number of 30 acute myeloid leukemia patients were recruited from Ain Shams University hospital, hematology and Oncology Unit outpatient clinic, with age ranging from 18-60 years old (median age 40 years), 14 of them were males representing 46.6% of the total number and 16 were females representing 53.3% of the total number. There was no statistical significance between the age of the studied group and the MRD with P-value 0.147, the sex of the patients doesn’t contribute to the risk stratification with a P-value of 0.200. The number of cases with negative MRD after induction was 13 representing 43.3% of the total number, and was 12 patients after 6 months representing 70.5% of the remitted patients, considering that the cut out value of MRD is 0.1. There was a significant relationship between TLC and MRD, the higher the TLC the more positive the MRD. Positive MRD is associated with higher mortality rates, exhibiting a statistical significance with P-value of 0.005. Conclusion We concluded that assessment of minimal residual disease in AML is of great value in determination of prognosis of the disease and its outcome and it is of great value to determine the levels of minimal residual disease (MRD) during the course of therapy and to stratify patient to identify high risk patient and to plan the therapeutic program accordingly.

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Background Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults. These malignant B-CLL cells represent over 99% of peripheral blood mononuclear cells (PBMCs) in CLL patients. In case of an aggressive form, the cell number may quickly double and, as a result, the disease may be fatal within a relatively short period of time .Currently several biomarkers are being used as CLL prognosticators, including: elevated protein levels (e.g. TCL-1, ZAP-70, CD38), elevated RNA levels (e.g. CLLU1, LPL, miRNAs), gene mutations (e.g.TP53, SF3B1, BIRC3, NOTCH1) and epigenetic changes. Early reports implicated IL-6 as pro-tumorigenic factor in various human tumors. IL-6 levels increased significantly in serum of CLL patients and correlated with adverse clinical features and short survival. Aim of the work Is to evaluate IL 6 level in patients with CLL at time of presentation and 6 months after chemotherapy and to study its relevance to disease prognosis. Patients and Methods This Study is a cross sectional study that was conducted on 55 patients newly diagnosed with chronic lymphocytic leukemia (CLL) in Clinical Hematology Unit in Ain-Shams University Hospitals in Cairo, Egypt. The control group included 50 healthy control subjects. Result The initial serum IL 6 level in the patient group (pre-treatment) ranged from 36-91pg/mL (median 57), and in the control group it ranged from 1-2 pg/mL (median 1).The initial serum IL 6 level in patient group (pre-treatment) range from 36-91 pg/mL (median 57), and in patient group (post treatment) range from 1-32 pg/mL (median 2).There are positive correlations between IL6 level and with WBC, B2 microglobulin, LDH, ESR, B symptoms, Uric Acid, BM Aspirate (% of lymphocytes)and Binet and Rai staging system. Conclusion Serum IL 6 is a useful poor prognostic marker in newly diagnosed CLL patients, its prognostic value goes with the other known prognostic markers as the lymphocytic count, ESR and LDH. Abbreviations: CLL (chronic lymphocytic leukaemia); IL-6 (interleukin 6).

Background Invasive fungal infection (IFI) is a major cause morbidity and mortality among patients with hematological malignancies who receive chemotherapy or hematopoietic stem cell transplantation (HSCT). Thus, early diagnosis and treatment of these infections are of crucial importance. Certain factors have been identified as risk factors for IFI. Objectives Assessment of incidence and outcome of IFI in Egyptian patients with febrile neutropenia. Patients and Methods 50 febrile neutropenia episodes were studied. Patients were all subjected to history taking, clinical examination and further investigations including imaging studies, Galactomannan and Mannan antigen assays, and patients were followed up for observing the outcome. Results Our study found that hypertensive patients had significantly reduced LA function as measured by speckle tracking when compared to normotensive controls (P-value < 0.001). Also, many factors were associated with worse LA function in hypertensive patients as old age, high BMI, DM, LV diastolic dysfunction, high LV mass index, larger LA size, lower LA expansion index and higher systolic BP. Conclusion IFI incidence is affected by age, gender, primary diagnosis and severity of neutropenia, and IFI has a worse outcome compared to other causes of febrile neutropenia.