Mitogen-Activated Protein Kinase 2 Relevance for the in-vitro Chemo-Sensitivity and Clinical Response in Children with Acute Lymphoblastic Leukemia in Mansoura University Hospitals

Background: Identification of different prognostic biomarker of pediatric ALL permits more characterization of patient subgroups and helps the risk-adapted treatment strategies. Aim: Our study assessed the role of Mitogen-Activated Protein Kinase (ERK1/2) as a prognostic biomarker of pediatric ALL in MUH patients. Further, detect the relevance of ERK1/2 for the in-vitro leukemic cells response to chemotherapeutic agents (Vincristine, L-asparaginase Dexamethasone and Doxorubicin). Material and Methods: ERK1/2 was measured in the bone marrow aspirates of 26 children with newly diagnosed ALL by ELISA technique. The MTT in vitro chemo-sensitivity assay was used to detect in-vitro leukemic cells response. Results: At diagnosis, the pERK 1/2 and tERK 1/2 are significantly higher in the HR gp than SR gp (p-value =0.000 & 0.003 respectively). While, the pERK/ tERK 1/2 ratio at diagnosis was significantly higher than that post induction in the patients of our study (p-value= 0.03). A significant association was detected between in vitro chemo-sensitivity to vincristine, l-asparaginase, dexamethasone & doxorubicin and complete remission after induction therapy (p-values = 0.004, 0.02, 0.02, 0.003 respectively). Conclusion: Our results indicated that ERK1/2 could be considered as an independent predictor of complete remission. In addition, in vitro chemo-sensitivity to the 4 drugs used was significantly associated with complete remission after induction therapy. Besides, a significant positive correlation was detected between ERK 1/2 and in vitro leukemic cells response to the four chemotherapeutic agents at diagnosis.