LASER AND NON-COHERENT LIGHT EFFECT ON PERIPHERAL BLOOD NORMAL AND ACUTE LYMPHOBLASTIC LEUKEMIC CELLS BY USING DIFFERENT TYPES OF PHOTOSENSITIZERS

Photodynamic therapy (PDT) is a novel treatment modality of cancer and non-cancerous conditions that are generally characterized by an overgrowth of unwanted or abnormal cells. Irradiation of photosensitizer loaded cells or tissues leads via the photochemical reactions of excited photosensitizer molecules to the production of singlet oxygen and free radicals, which initiate cell death. Many types of compounds have been tested as photosensitizers, such as methylene blue (MB) and photopherin seemed to be very promising. This study involved 26 cases of acute lymphoblastic leukemia and 15 normal volunteers as a control group. The cell viability was measured by Light microscope and flowcytometer. Mode of cell death was detected by flowcytometer and electron microscope in selected cases. The viability percentage of normal peripheral blood mononuclear cells (PBMC) incubated with methylene blue (MB) alone or combined with photo irradiation with diode laser (as measured by light microscope) was significantly lower than that of untreated cases either measured after 1 hour (p<0.001) or 24 hours (p<0.001) post incubation. There was a significantly lower viability percentage of normal cells incubated with MB and photoirradiated with diode laser compared to normal cells treated with MB alone for either measured after 1 hour (p<0.001) or 24 hours (p<0.001) post incubation. The decrease in viability was more enhanced with increasing the incubation time. For normal cells incubated with photopherin either for ½ an hour or 1 hour, there was a weak cytotoxic effect compared to the effect on untreated cells. There was a significant decrease in viability percentage of cells incubated with photopherin either for ½ an hour or 1 hour and photoirradiated with He:Ne laser compared to normal untreated cells. The decrease in the cell viability percentage was significantly lower with the use of PDT (photopherin and He:Ne laser ) compared to either photopherin alone or He:Ne laser alone. The decrease in viability was more enhanced with increasing the incubation time. The same effects reported on normal cells were detected on leukemic cells on comparing different methods used. However a more pronounced decrease in cell viability was detected. The most efficient ways of decreasing viability of leukemic cells with much less effect on normal cells was the use of PDT of cell incubation with MB for 1 hour then photoirradiation with diode laser and PDT of cell incubation with photopherin for 1 hour then photoirradiation with He:Ne laser. Flowcytometer (FCM) was more sensitivite than the light microscope in detecting the decrease in cell viability, it also helped in determining the mode of cell death weather apoptosis, necrosis or combined apoptosis and necrosis. Apoptotic cell percentage was higher in PDT of MB and Diode laser or photopherin and He:Ne laser, treated ALL cells compared to untreated ALL cells after 1 hour but was significantly lower after 24 hours post irradiation. A significant increase in necrotic, combined necrotic and apoptotic cell percentages either measured 1 hour or 24 hours post PDT, compared to untreated ALL cells and PDT treated normal cells. Electron microscope helped in detecting early cellular apoptotic changes occurring in response to different therapeutic modalities used in this study. In conclusion, PDT proved to be an effective clinical modality in decreasing the number of leukemic cells when irradiated in vitro with appropriate laser and photosensitizer system. Both PDT systems used in this study were efficient in inducing cell death of leukemic cells compared to untreated leukemic cells. However, photopherin PDT system was more efficient in decreasing the cell viability. A significant decrease in viability percentage was detected when studying the effect of PDT on leukemic cells compared to that on normal cells. This suggests that PDT when applied clinically will selectively differentiate between leukemic cells and normal cells, offering a successful component in ALL therapy.