Plasma Level of Tumor Necrosis Factor-alpha (TNF-α) Correlates with Leukocytosis and Biological Features of Leukemic Cells, but not Treatment Response of Children with Acute Lymphoblastic Leukemia

We have analyzed the clinical significance of the plasma level of tumor necrosis-alpha (TNF-α) detection in childhood acute lymphoblastic leukemia (ALL) at diagnosis. 49 patients (pts) with B-lineage ALL (3-17 years of age) and 30 healthy children (age-related control) were enrolled in study. The mean value of the level of TNF-α was 43.4 ± 8.1 pg/ml in ALL pts and 30.7 ± 3 pg/ml in control. In ALL pts the level of TNF-α positively correlated with blast cell count in peripheral blood (R = + 0.432; P = 0.008); negatively correlated with percentages of S-phase leukemic cells (R = - 0.446; P = 0.042) and culture-induced apoptotic cells (R = - 0.41 1; P = 0.057). Pts with TNF-α level above the median value were characterized by higher WBC count (P = 0.025), lower percentage of S-phase leukemic cells (P = 0.02) and tendency to lower percentage of apoptotic cells (P = 0.07) vs pts with TNF-α level below the median value. No significant association of the level of TNF-α with treatment response at days 8 and 15 or 3-year overall survival was defined. We conclude that the elevated plasma level of TNF-α is a useful marker to assess disease activity/progression, but not prognosis of childhood B-lineage ALL.