الفهرس 
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Abstract
chemotherapy resistance is a major problem in the management of patients affected by acute leukemia. overexpression or dysregulation of some oncogenes may have a crucial role in oncogenesis, by affecting intracellular growth controls, stimulating cytokine production and promoting or suppressing apoptosis. the aim of the present study is to assess gene expressions of p-gp, p53 and bcl-2 in acute leukemia (al) patients in mansoura hospitals and to correlate these levels with other known prognosis and patients’ outcome. the study comprised 48 patients with newly diagnosed al and 20 healthy volunteers with matched age and sex were taken as a control. all patients received treatment for al and were followed-up in an out patient department and observed over 24 months or until death. 17 patients died during the follow up time. our studies showed that p-gp, p53 and bcl-2 expressions were significantly elevated in the al patients compared to control group. also there was a highly significant increase in p53 and bcl-2 at diagnosis than at remission. regarding p-gp expression, a highly significant increase in al patients at remission compared to al patients at diagnosis. the comparison between non-survived and survived al patients show a highly significant increase in p-gp, p53 and bcl-2 expressions in non-survived patients compared to survived patients at diagnosis. from this study we conclude that proteins related to both apoptosis and multidrug resistance are among the most widely characterized drug resistance mechanisms leading to unsuccessful treatment of al. the measurement of p-gp, p53 and bcl-2 in acute leukemia patients at diagnosis deserves explanation in the prognostic evaluation of acute leukemia. overexpression of both p-gp, p53 and bcl-2 may reflect poor prognosis for which p-gp inhibitors and gene therapy is suggested to be used in future as adjuvant therapy to improve patient outcome