الفهرس 
Lymphoblastic LeukemiaOnly 14 pages are availabe for public view
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Abstract
Background Activin A belongs to the transforming growth factor-beta (TGFβ) superfamily of cytokines which exert a plethora of biological functions, including developmental differentiation, sex determination, control of cellular proliferation, migration and immune responses. Activins are dimeric glycoproteins that play a significant role in reproduction and in endocrine active tumors, although inhibins and activins have primarily been described in human gonads and identified as modulators of follicle-stimulating hormone production of the pituitary gland, they have also been detected in several solid tumor types, including endocrine-responsive endometrial, ovarian, and breast carcinomas. Their differential expression has suggested their important role in malignant cell transformation, as well as possible roles in cancer differentiation, proliferation, and growth tumors
Aim The aim was to assess expression of Activin A in the serum of adult patients with acute lymphoblastic leukemia and its influence on remission and survival of ALL patients.
Patients and methods Serum Activin A was measured using ELISA in 30 acute lymphoblastic leukemia patients and followed for 1 year in comparison to 15 healthy controls recruited from Hematology and Bone Marrow Transplantation Unit, Ain Shams University Hospitals.
Results Serum level of Activin A was elevated in acute lymphoblastic leukemia patients (ALL) in comparison to control group with a statistically significant difference (P<0.001).A statistically significant negative correlation was detected between age of the patients and Activin A level(P= 0.035). The comparison between different outcomes of the patients (Remitted, Relapsed and died patients) above and below the mean level of activin A (265.667 ng/ml),was statistically significant (P<0.00). A statistically significant negative correlation was detected between Activin A level in ALL patients and overall survival (OS) (P-value <0.001) and by using the log-rank test, a statistically significant difference (P-value <0.001) was detected in ALL patients above and below the mean level of Activin A. However, statistically nonsignificant difference was detected between the mean Activin A level in Philadelphia chromosome (Ph) positive and patient with Ph negative patients (P-value= 0.839)
Conclusion Activin A can be a useful poor prognostic biomarker in acute lymphoblastic leukemia patients, also it can be used as a predictor for aggressiveness of the disease, resistance and survival.