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Abstract
Malignant lymphoma represents a major health problem throughout the world. It ranks the fifth in cancer incidence in United States and is increasing at a rate of almost 7% per year. In Egypt, it constituted 11.7% of cases received at the National Cancer Institute (NCI) from 2003 to 2004 ranking the fourth among different cancers. The ratio of non-Hodgkin lymphoma (NHL) to Hodgkin lymphoma (HL) is 3.3:1 and B-cell tumors constituted 81.1% of NHL cases. B-cell NHLs are diverse group of lymphoid neoplasms with different natural histories and patterns of presentation. They can be divided into three prognostic groups: the indolent, the aggressive, and the highly aggressive lymphomas. At present, the most valuable and widely used system as guideline to therapy and prognosis is the International Prognostic Index (IPI). Redistribution of the IPI factors into the revised IPI (R-IPI) provides a more clinically relevant prediction of outcome. However, neither the IPI nor the R-IPI is an ultimate instrument and we are still in need to more accurate factors to predict prognosis and survival. De-regulation of apoptosis plays an important role in normal and malignant lymphopoiesis and apoptosis-related proteins might play an important role in the pathogenesis, prognosis, and sensitivity to the chemotherapeutical drugs in patients with B-cell NHL. However, there are few studies regarding the effect of apoptosis on the course and prognosis of B-cell NHL. Fas is a transmembrane protein of the tumor necrosis factor/nerve growth factor receptor superfamily that transmits an apoptotic signal in susceptible normal and neoplastic cells and mediates apoptosis after cross-linking with Fas ligand or specific antibodies. Resistance to Fas-