CLINICAL SIGNIFICANCE AND PROGNOSTIC VALUE OF SURVIVIN AND P53 IN CHILDREN WITH ACUTE LYMPHOBLASTIC LEUKEMIA

Background : Survivin is a member of the inhibitors of apoptosis (IAP) family , while P53 is a tumor suppressor protein which rapidly increases in response to cell stress , such as DNA damage. Both of Survivin and P53 are overexpressed in cancers including hematologic malignancy. Objective: To evaluate the level of survivin and P53 in children with acute lymphoblastic leukemia and to correlate it with clinical and hematological findings and response to treatment. Methods : The level of survivin was measured by ELISA and P53 expression was measured by flowcytometry in 37 children with acute lymphoblastic leukemia and 12 healthy children as a control group. The level of these two parameters was measured before and after treatment of patients and also correlated with clinical and hematological findings and response to treatment. Results : There was a highly significant difference in both serum survivin level and P53 expression between children with acute lymphoblastic leukemia at diagnosis compared to the control group , and the level has been significantly reduced after complete remission. Moreover , a significant positive correlation was found between serum survivin and LDH , WBCs count and percentage of blast cells in peripheral blood and bone marrow. Also , a significant positive correlation was found between survivin and P53 levels. Conclusion: The level of both survivin and P53 is significantly high in children with acute lymphoblastic leukemia and is positively correlated with poor prognostic factors , also survivin and P53 are positively correlated with each other.