الفهرس 
Acute Lymphoblastic Leukemia (ALL)Only 14 pages are availabe for public view
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Abstract
INTRODUCTION
Acute lymphoblastic leukaemia (ALL) is malignancy that arise from lymphoblast cells in bone marrow, and it is common childhood malignancy
The mutation that arises from lymphoblast caused by genetic mutations , or environmental factors that effect on epigenetics , sequentially affect apoptosis and cell proliferation and death by different pathways Numerous studies have linked an increased risk of ALL to polymorphisms in the following genes: Arylamine N-acetyltransferases 1 and 2, MMP-8 promoter genotypes, CEBPE, cell adhesion molecules and genetic mapping of malignant disease one of the challenge the scientist had to figure out.(Chiaretti et al., 2018)
Activated Leukocyte Cell Adhesion Molecule (ALCAM) is one of cell adhesion protein, also known as CD166 .one of theories for cancer metastasis is seed and soil through micro-embolic spread and loss of cell adhesion molecules integrity (Fares et al., 2020).
To prove this theory , many researchers had been studied the effect of ALCAM in cancers, Tachezy et al., 2012 had studied it is link to esophageal cancer and found Elevated serum ALCAM levels are associated with worse overall survival.
Another study by Devis and colleagues (2018) investigated ALCAM Serum levels and correlation a protein marker CA125/MUC16 in ovarian cancer and they found higher levels in patients than in control , higher level was associated with Aggressive tumors behavior and advanced stages of malignancies
Frequent studies had been done on solid malignancies and reaches to same conclusion , higher level of ALCAM was associated with Aggressive tumors behavior . As in study done by Chaker et al., 2013 in thyroid cancer .
another similar study by Hansen et al. 2014
higher in prostate cancer patients high ALCAM levels associated with metastases, nodal positive tumors, and those patients passed away from the disease.
CD166 expression on hematological cells: -
CD166 and ALCAM have also cited it as the CD6 ligand (CD6L) in some reviews contribute to the proliferation and differentiation of avian hemopoietic cells both Myeloid and Lymphoid precursors .It had two variant ALCAM heterophilic (ALCAM-CD6) and homophilic (ALCAM-ALCAM) cell-cell interactions. And involved of brain , immune system development and tumor progression (Jing Zhang et al., 2019)
There have been no recent studies on CD166 direct effect and relation to acute lymphoblastic leukemia but it had been studies over CD166 effect on hematopoietic stem cells growth, a wonderful study had been done by Chitteti et al 2014 , and they demonstrated that significance of CD166 in recognition and engraftment of HSC and play an important role in HSC-niche interactions.
(Maroun Bou Zerdan et al., 2022) found thatCD166 more expressed malignant plasma cells than normal plasma cells Additionally, CD166 increased RANK-L, which promotes osteoclastic differentiation and osteolytic activity.
The CD166-targeted CAR-T-cell treatment is still under clinical trials.
Aim of study and methodology: -
We assessed the expression of CD166 in newly diagnosed patients with acute lymphoblastic leukaemia using ELISA technique for detection of CD 166 expression, prior to the initiation of chemotherapy to determine the prognosis and clinical outcome. relationships with disease-free survival, overall survival, and relapse rate, as well as disease prognosis and treatment response, in patients recruited from the clinical haematology department of Ain Shams University Hospital.
Study population:
Inclusion criteria: 40 newly diagnosed patients between the ages of 18 and 60 with acute lymphoblastic leukaemia was included in the study
Exclusion criteria: patients older than 60 and younger than 18 with other cancers, severe heart, liver, or kidney problems, or who are pregnant. In comparison to 15 subjects age- and gender-matched healthy control subjects for comparison.
Each subject had full history taking, physical examination, CBC, and erythrocyte sedimentation rate (ESR). Liver and kidney function, serum electrolytes, and LDH, bone marrow aspiration, flowcytometric evaluation standard cytogenetic evaluation, and fluorescence in situ hybridization (FISH) CT of the neck, chest, and pelvic-abdominal for detecting tumor load. Serum CD166 enzyme-linked immunosorbent assay (ELISA) measurements at diagnosis and prior to chemotherapy The Ethical Committee approved the study, and informed consent was obtained from patients and control subjects prior to sample collection. Ethical Implications: After explaining the purpose of the study, all participants will provide written informed consent. Before conducting the study, the protocol will be approved by the local ethics committee of the Department of Internal Medicine. Analytical statistics: categorical variables are expressed as percentages, while continuous variables are expressed as mean and standard deviation. Statistical collection: SPSS will be utilized to conduct every statistical analysis (SPSS Inc., Chicago, IL