Sialic acid—rich glycoprotein binds selectively in human and other organisms cancer cells that can metastasize .This helps these late stage cancer cells enter the blood stream. Biological markers can be used to monitor cancer elevation in the serum. Total sialic acid (TSA) concentration was observed in a number of cancer types, the chemotherapy is used as the only cancer treatment. The present study included 5l patients age (4—69 year) with leukemia, they were included 13 patients with acute lymphoblastic leukemia (ALL), 13 with acute myelogenous leukemia (AML) and 25 with chronic lymphocytic leukemia (CLL). This study included also 50 healthy subjects as normal control, all the patients had chemotherapy. The study included measurements of fasting serum total sialic acid (STSA) level, which is significantly increased in post sampling of leukemia patients compared with normal control subjects. A higher significant difference of STSA at the first week during chemotherapy in the three type of the leukemia patients, also there were significant difference of STSA level at the third week during chemotherapy in the ALL and AML patients. On the other hand, there were no significant differences in STSA level after five weeks of chemotherapy treatment for ALL and AML patients. According the duration of chemotherapy dose there were significant differences in STSA level between the first dose week and third dose of chemotherapy. Also, there were significant differences between the first weeks and 5th weeks of chemotherapy treatment for ALL and AML patients.