Correlation between survivin over expression and prognosis in pediatric all: a systematic review

Acute lymphoblastic leukemia (ALL) is the utmost common malignancy identified in children, representing nearly one third of all pediatric cancers that described by the clonal proliferation and increase of malignant blast cells in the bone marrow and peripheral blood. Relapsed acute lymphoblastic leukemia (ALL) in pediatric presents a significant challenge and accounts for more mortality than any other malignancy. Anti-apoptotic properties by such regulatory gene expressions would clinically offer a significant growth benefit and reveal malignant behavior in tumors. Survivin is an onco-fetal protein that is localized at chromosome 17 and has 4 exons and 3 introns. It is expressed in embryonic lifespan and in several cancers. Survivin is a unique apoptosis suppressor and is thought to play a role in oncogenesis also is regulates cell division. The prognostic value of survivin in leukemia has not been as broadly studied as in solid tumors and in pediatric ALL patients has not been systematically reviewed. Hens, this present study aimed to determine the prognostic value of surviving expression in ALL pediatric. We searched the following databases including: PubMed, Google scholar, EMBASE, Scopus and ISI published up May 2017. We using the conformity keywords in various combinations: ALL and survivin or Acute lymphoblastic leukemia and survivin or survivin and pediatric or childhood or infant and prognosis and survivin and ALL. The keywords were planned to suitable MeSH terms. A total of 4 article were studied. Three article reported that rate of survivin expression was between 41.9% - 65% and one study declared that in ALL-L3 rate of gene expression higher than ALL-L2 and L1 detected. Three of four paper stated that there is no relationship between survivin expression and gender or age of patients.one study declared no association between WBC count and surviving expression but another study reported that was a significant correlation between gene expression and WBC count (p=0.012). One study declared that rate of OS (p=0.005), EFS (p=0.01), RFS (p=0.02) was lower in patient with sur vivin over expression. Another two study revealed that level of CR in high survivin expression patients significantly lower than other patients. According to the result of studies review, high expression of survivin may play an important parameter to determine poor prognosis in ALL pediatric and it may candidate to refine treatment in those patients prone to relapse

Keywords:

Blood Cancer , Gene and Cancer , Cell and Cancer , Cancer Risks , Cancer Genetics