Abstract :
Survivin, one of the inhibitors of apoptosis proteins (lAPs) and BCL2, a member of the BCL2 family, are two proteins implicated in the inhibition of apoptosis with the resultant imbalance between cellular proliferation and death, a mechanism that plays a role in leukemogenesis. To assess the pattern of expression and the prognostic impact of those two molecules in childhood precursor B-ALL, this study was conducted in Ain Shams University Hospitals on 30 patients, 16 males and 14 females (male to female ratio = 1.1:1), with a mean age of 80 months (range = 6 - 186) together with 12 controls. They were subjected to complete blood count (CBC), bone marrow (BM) examination, cytochemistry, immunophenotyping and intracellular detection of survivin and BCL2 by flow cytometry. Immunophenotypically they were 3(10%) pro-B-ALL, 20 (66.7 %) cALL and 7 (23.3 %) pre B-ALL. Survivin was found to be expressed in 19/30 (63.3 %) of cases with no relation to blast maturity and no significant correlation with known prognostic indicators (age, sex, WBCs). However, survivin expression proved to be a relative unfavorable independent risk factor with a shorter overall survival time inpatients expressing it. On the other hand, BCL2 overexpression was found in 18/30 (60 %) of cases, with no relation to blast maturity, no significant correlation with proved prognostic indicators, no relation to clinical outcome or overall survival time. These findings display the negative impact of survivin in childhood precursor B-ALL making it candidate for use as a marker of poor prognosis.
