Evaluation of tumor necrosis factor-alpha and interferon-alpha with some biochemical parameters in different groups of chronic myeloid leukemia patients in Baghdad

     Chronic myeloid leukemia (CML) is a myeloproliferative disorder caused by the BCR/ABL oncogene and characterized by clonal expansion of the hematopoietic progenitor cells and myeloid cells resulting from the (9:22) translocation. The aim of this study is to investigate the extent to which tumor necrosis factor-α and interferon- α and some biochemical parameters are involved in chronic myeloid leukemia in blood samples of patients with newly diagnosed patients. The effect of pharmacological interventions (imatintb) on theses parameters were also investigated in treated CML patients. Blood samples were obtained from 30 male and female CML patients (with either newly diagnosed and treated) referred to the national center of hematology, ALMustansiriya university,and the office of teaching laboratories-medical city, Baghdad.The CML patients included 15 newly diagnosed patients (7 men and 8 women) with a mean age of 49.7 ± 10.6 year and an age range of 32-69 year. Another 15 treated CML patients (8 men and 7 women) with a mean age of 55.13 ± 13.6 year and an age range of 32-75 year were involved in this study. The range of duration of CML was between 3 months to 7 year. Fifteen apparently healthy controls (8 men and 7 women) with a mean age of 57.6 ± 14.2 year and an age range of 30-72 year are also involved in this study. The plasma levels of tumor necrosis factor-alpha (TNF-α) and interferon-alpha (IFNα) were measured. To investigate the role of oxidative stress in the pathophysiology of CML patients, plasma glutathione (GSH) levels were estimated. Erythrocytes were also examined for their susceptibility to in vitro oxidative stress-induced by H . Criteria studied in this regard was malondialdehyde (MDA) production (an index of lipid peroxidation). The results obtained showed a significant increase in plasma TNF-α in newly diagnosed CML (but not in the treated CML) patients. Plasma GSH levels were significantly decreased in newly diagnosed CML patients. Furthermore, red cells from newly diagnosed CML patients showed an increased levels of both basal and H 2O 2 2O2 induced MDA production.   In conclusion, the present results revealed the presence of alterations in the immune system of the CML state. The decline in plasma GSH levels, together with the elevation in both basal and H 2 O-induced MDA levels in erythrocytes of newly diagnosed CML subjects suggest the presence of increased susceptibility to oxidative stress in CML. The 2 ability of the anti-leukemic imatinib or linotinib to normalize most of the alterations are suggestive of a possible, among others, antioxidant mechanism of activity of these drugs.