الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: Acute lymphoblastic leukemia (ALL), an aggressive type of leukemia is a malignancy of the bone marrow in which white blood cells are stuck in the immature forms of development (blasts) and are incapable of maturing or carrying out basic functions. Therefore, the blood stream becomes clogged with lymphoblasts that accumulate in the bone marrow and crowding out the bulk of normal cells. Leukemic stem cells (LSCs) are the major cause of the recurrence of ALL even after aggressive treatment. So, the development of an effective treatment targeting this fatal disease was urgently needed.
Aim of the work: This study aimed to develop an effective anti-cancer agent targeting these LSCs. Luffa Cylindrica (L. cylindrica) leaves extract was selected to evaluate its effect on ALL via eradicating the LSCs as it contains many active anti-cancer flavonoids.
Methods: Thirty-two bone marrow samples of ALL patients were used in this study. LSCs population was identified in the selected samples. Cell viability was measured by MTT assay and flow cytometry. Cell cycle, apoptosis, proliferation marker; ki-67 and colony forming assay were further analyzed.
Results: This study revealed the expression of CD34+/CD38+ cells in addition to CD34+/CD38- population and the extract was effective against the two LSCs populations. MTT assay showed that treated leukemic cells exhibited significant reduction in the viable cells in a dose dependent manner with IC50 of 3 µg/µl which was then confirmed by flow cytometry. Cell cycle analysis results showed significant reduction in the percentage of cells treated with L. cylindrica extract in both the S and G0/G1 phases,
with concomitant increase in the G2/M phase. Also, L. cylindrica extract could effectively induce apoptosis, inhibit proliferation and suppress colonogenecity of leukemic cells.
Conclusion: This study validated the medicinal potential of L. cylindrica leaves extract as a promising anti-leukemic agent targeting both LSCs and blasts in ALL patients, which may be explained by the synergy found between its potent flavonoids.