Background
Acute leukemias are malignant neoplastic diseases that arise from either lymphoid [ALL] or myeloid [AML] cell lines that are distinguished by the proliferation of BM non-functional immature cells and subsequently released into the bloodstream. ALL is prevalent malignancy in young, while AML in older. Diagnosis is usually routinely performed through peripheral blood count and smear then confirmed by BM aspirate. It is remarkable to notice that leukemia can be manifested at high, low, and even at normal leucocyte count. While treatment results have improved steadily over the last decades in younger and adults, limited changes have been in survival among subjects of age > 60 years. Aim of the work is to measure the serum estrogen [E2] and its soluble receptor [ER] levels in acute leukemia patients and extrapolate its possible clinical significance. This study included 40 [20 females and 20 males] healthy volunteers clinically free from any disease, 40 [20 females and 20 males] AML patients, and 40 [20 females and 20 males] ALL. To all subjects, serum E2 and its soluble ER level were investigated by ELISA.
Results
Serum E2 [pg/ml] level was lower in AML and ALL female and male patients groups than control group. Serum ER [ng/ml] level was lower in AML and ALL female and male patients groups than control group.
Conclusion
Estimation of serum E2 and its soluble ER level is of edifying diagnostic value. Determination of serum E2 and its soluble ER level in AML and ALL patients is of value in deciding treatment therapeutic target protocol.
Objectives: To identify leukemia-associated immunophenotypes in fifty acute myeloid leukemia patients at diagnosis using an eight color multiparameter flow cytometry panel and to detect if they showed any alteration in relapse/refractory cases. Methods: Eight color multiparameter flow cytometry panel with CD45/SSC log gating strategy was used for analysis of leukemia-associated immunophenotypes in fifty acute myeloid leukemia patients presenting to Alexandria University Hospitals at diagnosis, relapse and refractory cases. Twenty bone marrow samples from patients performing bone marrow aspirate for non-malignant hematological indications of matched age and sex were included as controls. Results: Leukemia-associated immunophenotypes were observed in 43 cases (86%). Only one aberrant immunophenotype was identified in four cases (8%), while two to twelve aberrant immunophenotypes were found in the other 39 cases (78%). Strong leukemiaassociated immunophenotypes were obtained by the combination of CD2, CD4, CD56 with either CD34 or CD117, in contrast to CD19 which has to be combined with CD117. Refractory cases showed the presence of same LAIPs at both initial diagnosis and persistent 2 disease, while one of the relapsed cases showed acquisition of new leukemia-associated immunophenotypes after relapse. Conclusion: The good choice of leukemia-associated immunophenotypes depends on their specificity rather than their frequency. The results of this study can help in increasing the sensitivity of leukemia-associated immunophenotypes strategy in minimal residual disease using multiparameter flowcytometry in acute myeloid leukemia patients which is considered an important post-diagnosis parameter associated with prognosis and clinical outcome.
Background
Minimal residual disease (MRD), which is characterized as leukemic cells at a level below morphologic detection, has been connected to the risk of relapse in acute myeloid leukemia. In 80–90% of acute myeloid leukemia (AML) patients, the Wilms tumor (WT1) gene is overexpressed at the mRNA level. In our prospective study, a total of 55 patients were enrolled in the study. Group I involved 40 AML patients and group II involved 15 patients healthy controls. WT1 gene expression was quantified using quantitative real-time PCR on bone marrow samples from AML patients at initial diagnosis and at day 28 after induction chemotherapy, and compared to 15 healthy controls in group II. Follow up of patients for prognosis evaluation was assessed. IBM SPSS software was used to capture and analyses the data.
Results
At diagnosis, the mean WT1 transcript value in AML patients was substantially higher than the expression observed in control patient’s Bone marrow. There was no statistically relevant relationship between the onset of relapse and WT1 expression. Patients with WT1 overexpression at diagnosis had a shorter overall survival than patients with negative WT1 expression.
Conclusions
Wilms tumor 1 gene expression was found to be significantly higher in AML patients than control cases, overall, our results confirmed the prognostic significance of WT1 overexpression in AML patients. Our findings support the application of MRD in AML patients based on WT1 overexpression.
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