الفهرس | Only 14 pages are availabe for public view |
Abstract From the initial studies, angiogenesis is well established to be vital for solid tumors, while its importance for hematological malignancies was reported later. The aim of the present study is to evaluate the prognostic importance of angiogenesis markers [platelet derived growth factor-BB, interleukin-8 (IL-8), hepatocyte growth factor (HGF) and endoglin (CD105)] in patients with non Hodgkin’s lymphoma (NHL), and to identify their significance on treatment response. The serum levels of angiogenesis markers were measured in aggressive NHL patients before and after chemotherapy by ELISA technique and compared to healthy control group, and their relation to some clinical features was assessed. The laboratory investigations carried out were: blood picture, erythrocyte sedimentation rate (ESR) plus biochemical evaluation including: estimation of serum aminotransferases (ALT, AST) activities, serum levels of total bilirubin, albumin, creatinine, uric acid, lactate dehydrogenase (LDH), ß2-microglobulin (ß2-M). Within the confines of this study, PDGF-BB is not considered to be vital in the pathogenesis of the disease. The most important finding is that chemotherapy led to elevation of serum PDGF-BB reflecting activation of angiogenesis which can be considered one of the mechanisms of conferring chemoresistance to cancer cells or identifies patients at risk to develop side effects. Hence, if this effect of chemotherapy is confirmed by future investigations which we recommend, the combined use of antiangiogenic drugs with chemotherapy might be capable of inhibiting the consecutive activation of angiogenesis, thus might augment the therapeutic effect as development of resistance to chemotherapeutic agents is a major problem in treatment of cancer. IL-8 was found to have a probable role in the pathogenesis of NHL. It may have a possible role in disease dissemination. A possible favorable prognostic value of a high pretreatment level of IL-8 is suggested that may need further conformation. The pathogenic and angiogenic importance of HGF in NHL is confirmed in this study and its prognostic value is affirmed by its association with treatment response suggesting that the serial determination of serum HGF levels could represent an important clinical tool in monitoring the chemotherapeutic response. The current study is one of the pioneer studies exploring the role of endoglin in the progression of NHL disease, and proves its angiogenic importance in the advanced stages. Its prognostic role is also verified reflecting the tumor load and its growth and invasive potential. While chemotherapy has a suppressive effect on CD105 level, the use of antiangiogenic factors blocking CD105 angiogenic pathway may be a promising approach in the treatment of NHL. |