الفهرس 
Acute Myeloid LeukemiaOnly 14 pages are availabe for public view
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Abstract
A
cute myeloid leukemia (AML) is a clonal hematopoietic stem cell disorder, characterized by arrested differentiation, inappropriate proliferation and survival of immature myeloid progenitors. The AML has the lowest survival rate of all leukemias, so, assessment of the prognostic factors in AML is very important.
The modern characterization of AML is a multi-disciplinary process. It requires the integration of clinical informations, morphology, cytochemistry, immuno-phenotyping, cytogenetic diagnostic techniques. It is only by bringing all these modalities together that a clear picture can be presented.
FLT3/CD135 is a member of the class III kinase family receptor and predominantly expressed in haematopoietic cells restricted to the CD34 positive fraction, in addition FLT3 plays a role in cell survival, proliferation, and differentiation.
FLT3 mutations are one of the most frequent somatic alterations in AML. In addition the FLT3 protein is expressed on blast cells from most AML.
The present study aimed to assess CD135 expression in patients with AML, and to evaluate its association with the different demographic, clinical and laboratory data, as well as its relation to disease outcome.
The current study was carried out on 30 newly diagnosed AML patients but the statistical analysis was carried on 20 patients only due to deterioration in reagent. As well as twenty age and sex matched healthy subjects as a control group. All patients were subjected to complete history taking, thorough clinical examination and laboratory investigations including: complete hemogram, bone marrow aspiration with examination of Leishman-stained peripheral blood and bone marrow smears, immunophenotyping and detection of the level of CD135 expression by flow cytometry.
CD135 was expressed in 80% of patients, while none of control group expressed CD135 (p=0). CD135 expression was not correlated with any of the studied demographic, clinical and laboratory data except for PB blasts, BM blasts and HLA-DR (p= 0.048, 0.001 and 0.002 respectively).
In this study 25% of patients showed good disease outcome while 75% showed bad disease outcome. A statistically significant association was elicited between CD135 expression and disease outcome. The AML patients with high FLT3 expression group had poorer outcome than the group with low expression. (p=0.04).
Comparative statistical analysis between good and bad outcome showed the increase in BM blasts as well as FLT3 expression coincided with bad disease outcome, while increased CD13 expression coincided with good disease outcome. (p=0.049).
Finally, the results of the present study confirmed that FLT3 expression is a prognostic predictor for AML being associated with poor outcome. Additionally, the present data indicated that CD135 surface expression is an important marker in AML which can rapidly and easily be detected by FCM. The FLT3 expression, therefore, should be incorporated into the initial laboratory work-up and risk-stratified treatment strategies for all newly diagnosed AML patients.