Assessment of Circulating (ki-67) in Allogenic Stem Cell Transplantation for Adult Patients with Acute Leukemia Thesis

Abstract

The acute leukemias are a heterogenous group of neoplasms arising from the transformation of uncommitted or partially committed hematopoietic stem cells. Acute leukemias are divided into myeloid (non lymphobalstic) and lymphoid. Further subclassification of each group has become essential, as treatment is evolving for specific genetic groups of disease. The primary objective in treating patients with acute leukemia is to induce remission and thereafter prevent relapse. Treatment is conventionally divided in to two phases; induction and post induction. The first attempts to produce complete remission. The second phase of therapy aims to prolong the complete remission. For patients with poor risk features and those who have poor response to chemotherapy, allogeneic HSCT is considered the only curative therapy, because of its distinct advantage of the graft-versus-leukemia (GvL) effect. However, several problems remain to be further determined, such as the selection of the suitable candidates for HSCT, optimal sources of donors, and timing for the procedure as well as preparative regimen, and how to overcome the transplant rejection or graft versus host disease (GvHD), and control or avoid the transplant-related complications. Ki 67 is a nuclear antigen expression of prognostic importance in variety of solid and hematologic cancers. As