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Apoptosis and Tumour Necrosis Factor in Children with Hodgkin’s Disease

1Ahmed K Mansour, 2Samia Hawas, 2Medhat M Ali, 3Basem El deeke & 4Eman El-Nashar.

The Departments of 1Pediatrics, 2Microbiology & Medical Immunology, 3Biostatistics & Community, Faculty of Medicine, Mansoura University and 4Histology & Cytology department, Benha Faculty of medicine.

Although Hodgkin’s disease is highly responsive to treatments which may cause apoptosis, it remains resistant to the physiological mechanisms intended to cause cell death. This study was performed to assess apoptosis, tumor necrosis factor (TNF), and soluble TNF receptors (TNFR) (P55 and P75) as a prognostic risk assignment in 28 children with Hodgkin’s disease and 28 healthy controls. The results revealed that apoptosis & plasma levels of TNF, TNFR-P55 and TNFR-P75, were higher in children with Hodgkin’s disease than in healthy controls (P< 0.001). High levels were associated with several prognostic, factors including those related to the host (age, performance status) and to the tumour (disease stage, extranodal site involvement and bulky tumour). In the mean while elevated plasma levels of TNF, TNFR-P55 and TNFR-P75 were associated with several parameters reflecting an immune activation, including the presence of severe symptoms (P< 0.001), splenomegaly (P<0.001) histological grading (P<0.05) and hemoglobin level (P< 0.05). In addition, elevated TNF-a was associated with a lower incidence of complete response to therapy and predicted shorter free-from-progression survival (P< 0.001) and overall survival of the children with Hodgkin’s disease. These results indicate that the plasma levels of TNF, its soluble receptors and apoptosis correlate with clinical features and outcome of Hodgkin’s disease in children.