الفهرس 
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Abstract
This study aimed to assess the prevalence of aberrant expression of CD markers in cases with acute leukemia in Sohag University Hospitals.
This study was carried out in the Clinical Pathology Department, faculty of medicine, Sohag university hospital.
In this study we performed complete blood count, BM aspiration examination and flow cytometry panel for diagnosis and lineage assignation of acute leukemia flow cytometer for fifty (50) newly diagnosed acute leukemia patients who were subdivided into 3 groups ; group (I):AML patients, group(II): B-ALL patients and group(III): T-ALL patients.
Out of 50 cases, 32 (64%) cases were of AML and 15 (30%) of B-ALL and 3 (6%) of T-ALL. In this research, FAB studies on AML patient showed that AML-M4-M5 was the most common subtype of AML.
The incidence of aberrant phenotypes in all cases of acute leukemia to be about 27 out of 50 (54%) acute leukemia cases; 17 of 32 (53%) in group (I), 7 of 15 (47%) in group(II) and 3 (100%) in group (III). So, more than 40% of the studied cases exhibited conventional B-cell, T-cell and myeloid immunophenotypes.
The aberrancy was seen in 100% of T-ALL and 46% of B-cell ALL cases and 53% of AML cases. Orderly more aberrant expression of CD antigens was seen in T-ALL, then in AML and then in B-ALL cases.
Regarding the aberrant antigens expression in B- cell ALL, it was shown that CD33 and CD13 were the most common markers expressed in 13% and 20% respectively.
CD7, CD5 and CD3 were the positive T-cell markers that observed in AML cases in 28%, 6% and 3% respectively, none of the T-cell antigens were positive in B-cell ALL in the current study.
In T-cell ALL, CD13 and CD33 which are myeloid antigens and CD 19 which is a B-cell antigen, were the antigens expressed equally, each was 33%.
With regards to the paired aberrancy, our study showed that CD13 and CD33 weren’t co-expressed in B-ALL and T-cell ALL.
Among the aberrant AML cases, we found that CD7 was the most common aberrant marker expressed in 9 cases (28%), CD19 was expressed in 3 (9%) of our cases. According to TdT we found 2 cases of 32 (6%), CD5 was expressed in 2 cases of 32 (6%). CD3 was positive in 3% of AML patients.
Comparing splenic affection, hepatomegaly and lymphadenopathy between three studied groups revealed no stastical significance.
Comparing total WBCs count in the studied groups revealed no stastical significance.
Comparing HGB level between group (I) with group (II) revealed no statistical significance while group (I) with group (III), group (II) with group (III) revealed statistical significance.
Comparing platelet count in the studied groups revealed no stastical significance.
Comparing peripheral blood Blast cells in the studied groups revealed no stastical significance.
Comparing bone marrow Blast cells in the studied groups revealed no stastical significance.
No significant differences were noted between classical and aberrant acute leukemias regarding age, sex and blasts count.
In conclusion:
We conclude that aberrant expression of CD markers is seen in several cases of acute leukemia. The frequency of aberrant antigen expression in acute leukemia was comparable with most published international data. The presence of aberrancy helps to identify a neoplastic process.
Recommendations:
1. Aberrant expression of CD markers studying can be recommended for evaluating disease progression (prognostic factor) in acute leukemia as regard survival rate and disease relapse.
2. Aberrant expression of CD markers studying can be useful in detection of Minimal Residual Disease (MRD).
3. Further studies are recommended to confirm the correlation of aberrant phenotypes in diagnosis, prognosis and therapeutic response of acute leukemia.
4. Molecular cytogenetic studies are recommended to shed light on potential biomarkers that might play a role in pathogenesis of antigen aberrancy, prognostic stratification and possible drugable target.