The clinical course of Myelodysplastic Syndromes (MDS) are very heterogeneous, with a wide diversity in patient's outcome. Whilst near one third of MDS progress to AML; the other two thirds transformed from low risk into high risk MDS (Garcia-Manero 2015
BACKGROUND: Acute myeloid leukemia changes the bone marrow (BM) niche to support leukemia cells by modulating the stromal microenvironment. The aim is to assess Activin-A as a biomarker in acute myeloid leukemia (AML). METHODS: The level of Activin-A and CXCL-12 protein concentration levels in the plasma of bone marrow aspirate samples of eighty AML patients at diagnosis, after induction and at relapse were determined by ELISA. RESULTS: We found that Activin-A concentration levels was significantly up regulated in AML cases at diagnosis, and down regulated at complete remission and rise again at relapse (P< 0.001). In contrast; the CXCL-12 gene expression was significantly down regulated in AML cases at diagnosis; relapse, and up regulated after complete remission (P< 0.001). Multivariate analysis showed that high Activin-A levels at diagnosis is significant predictor of induction of remission response OR 1.006 (CI: 1.002–1.010) (P= 0.003); AML relapse OR 1.002 (CI: 1.0–1.004) (P= 0.043) as well as patients’ outcome OR 1.33 (CI: 1.004–1.062) (P= 0.024). CONCLUSION: Activin-A level at diagnosis is a new simple easily assessed biomarker that could predict AML patient’s response to therapy as well as patient’s outcome.
This study aimed to determine the clinical impact of CD25+/CD123+ coexpression in adult B-cell acute lymphoblastic leukemia (B-ALL) cases. One hundred and twenty newly diagnosed B-ALL patients (≤60 years old) were included in this study. CD123 and CD25 expression on leukemic blast cells were assessed using flow cytometry. CD25+/CD123+ coexpression was detected in 40/120 B-ALL patients (33.3%). All B-ALL patients showed CD25+/CD123+ coexpression had lower induction of remission response and shorter overall survival as compared to B-ALL cases lacking coexpression. In conclusion, CD25+/CD123+ positive coexpression is a reliable flow cytometry marker for prediction of the outcome of adult B-ALL patients and could be used as a novel parameter for risk stratification of adult B-ALL cases.
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