الفهرس 
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Abstract
Chronic myelogenous leukemia (CML) is a type of myeloproliferative neoplasm associated with a characteristic chromosomal translocation called the Philadelphia chromosome (Azzazi et al., 2021).
Most patients are diagnosed during the chronic stage which is most often asymptomatic (Asif et al., 2021).
Since the development of tyrosine kinase inhibitor (TKI) therapy, the outcome of CML patients in the chronic phase has improved considerably (Musaelyan et al., 2021).
Aim of the study:
To measure the fluctuation in the levels of TGFβ1, and sVCAM-1 during treatment with TKIs and clarify the clinical and immunological significance of these biomarkers.
Patients and methods:
A cohort study was conducted at Assiut University Hospitals, Department of Internal Medicine, Clinical Haematology Unit, Assiut, Egypt. Following informed consent. The study began with 54 persons who were divided into two groups: 36 CML patients and 18 controls.
Patients with CML were separated into three groups: imatinib group (14 patients), nilotinib group (12 patients), and dasatinib group (10 patients). Correlations between the groups and patient characteristics, clinical data, and laboratory findings were then reevaluated.
All the patients included in this study subjected to the following: Clinical examination and laboratory investigation (TGF-β1 & sVCAM).
Results:
This study was conducted on 36 CML-CP patients and 18 healthy controls.
• There was highly significance difference (P<0.001) regarding spleen diameters, fatigue, pallor, weight loss without trying, fever, loss of appetite and bone pain in imatinib group throughout the follow up period compared with before treatment in each group except bleeding and bone pain in nilotinib group and dasatinib group. There was a non-significant difference (P>0.05) between three groups regarding all clinical data.
• A highly significant decrease in the BCR-ABL, TGF-B1 and sVCAM were recorded after treatment in three groups group (P<0.01), compared with their respective base line value inside each group.
• Dasatinib treatment was the most effective in decrease levels of TGF-B1 and sVCAM than others group (P<0.001).
• TGF-B1 levels were moderately correlated with clinical parameters (spleen, fatigue, weight loss without trying, fever, easy bleeding, loss of appetite, bone pain and pallor) and WBCs among cases and it was statistically significant.
• There was a positive moderate correlation between sVCAM level and clinical parameters except bone pain and pallor. In addition to a positive moderate correlation with WBCs.
• There was a positive moderate correlation between BCR-ABL, sVCAM and TGF-B1 levels.