الفهرس 
Introduction & aim of the work
Continuation treatmentOnly 14 pages are availabe for public view
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Abstract
Leukemias are group of heterogeneous neoplastic disorders of white blood cells. Based on their origin, myeloid or lymphoid, they can be divided into 2 types, acute lymphoblastic leukemia (ALL) and acute myeloblastic leukemia (AML). Acute lymphoblastic leukemia (ALL) is one of the most common malignancies diagnosed in patients younger than 15 years, accounting for onefourth of all cancers and three quarter of all leukemias in this age group. It has been estimated that 231,000 new cases of leukemia were diagnosed globally during 1990. Natural killer cells (NK) play an important role in control of growth of tumors as it can kill susceptible tumors as they have direct cytolytic activity against various tumor cells, including leukemic cells and also release a variety of cytokines that affect other hematopoietic cells and alter their function. Tcell response is one of the most important host responses for control of the growth of antigenic tumor cells; Tlymphocytes secrete lymphokines that activate other immunological cells as macrophages, NK cells and B cells. Cytokines play a role in defense against malignancy, IL2 is essential for stimulating T and Blymphocytes and it has antitumor effect due to its ability to activate the tumor killing cells, monocytes and NK cells. IFN has been reported to play a role against cancer and it is indicated for the treatment of certain leukemias. This study comprised 25 leukemic patients besides 15 apparently healthy individuals as a reference group. The patient group comprised 17 males and 8 females diagnosed as acute lymphoblastic leukemia. Their ages ranged from 3.5 to 10 years. Diagnosis was confirmed by bone marrow aspiration as well as cytochemistry. The patients and control groups were subjected to the following: 1Detailed history taking, complete clinical examination as well as the following investigations: CBC, ESR, liver function tests, serum creatinine, LDH, serum uric acid, BM aspiration cytology and cytochemistry. 2 Immunological investigations including: CD16, natural killer cells cytotoxicity, interleukin2 and interferon gamma. from the present study, one can conclude the following: A) As regards hematological findings: There are significant statistical differences in polymorph nuclear cells and lymphocytes ratio, Hb concentration, Hct, MCH, TLC, blast cells and platelet count in patients before therapy and control group. There are significant statistical differences in Hb concentration, Hct, MCV, MCH and TLC after chemotherapy and control group. There are statistical significant difference in polymorph nuclear cells ratio, ESR, Hb concentration, HCT, platelets and blast cells before and after therapy. B) As regards biochemical findings: There are significant differences between the three studied groups as in uric acid and LDH. There are statistical significant differences in albumin, total bilirubin, AST and ALT in patients after therapy and control group as well as in patients before and after therapy. C) As regards immunological findings: There are a significant statistical differences in IFNgcs, IL2 and NK cytotoxicity between the three studied groups. Conclusion: We can conclude that NK activity is remarkably depressed in ALL patients and cytokines can increase NK activity and may be of important role in immunotherapy of acute leukemia.