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Background. B-cell acute lymphoblastic leukemia (B-ALL) is a malignancy of immature B-cell precursors that proliferate in the bone marrow leading to signs and symptoms of bone marrow failure. Clinical, biological and genetic features are having prognostic significance affecting the outcome of those patients. We aimed with this study to analyze the significance of these factors in affecting patients outcome after treatment with complete or incomplete remission. Patients and methods. This study was carried out on 39 adults B-cell ALL patients who were attending the hematology oncology clinics. All patients were subjected to; History, clinical examination and Laboratory investigations, which included CBC, PB and BM examination, Immunophenotyping and Fluorescence in situ hybridization. Results. This study was carried out on 39 adult B-cell ALL patients ( Follow up was done at day 28 of chemotherapy) show: 16 (41%) patients achieved complete remission (CR) ; while 23 (59%) patients showed incomplete remission (IR). Statistical analysis of patients' outcome with prognostic markers revealed significant association (p<0.05) of CR with TLC <50x109/L (p=0.003) , age <35 yrs (p=0.000) and frequency of t(9;22) with (p=0.05 ). Conclusion. Age, TLC and t(9;22) are represent the most significant standard prognostic factors in relation to adults B-ALL patients' outcome.

Background: Acute lymphoblastic leukemia (ALL) is a hematologic malignancy which results from accumulation of lymphoid progenitor cells in the bone marrow and/or extramedullary sites. Philadelphia chromosome (Ph 1) positive ALL, a high-risk cytogenetic subset, accounts for 25%-30% of adult ALL cases but occurs in less than 5% of children. We aimed with this study to detect BCR-ABL genes fusion, amplification and deletion in ALL patients, using extrasignal-fluorescence in situ hybridization (ES-FISH), and to assess their relation with other standard prognostic factors and therapeutic response. Patients and Methods: This study was carried out on 39 newly diagnosed ALL patients. All patients were subjected to: history, clinical examination and laboratory investigations, which included complete blood count (CBC), peripheral blood (PB), bone marrow (BM) examination, immunophenotyping and fluorescence in situ hybridization using extra-signal probe to detect BCR-ABL genes fusion. Results: This study showed statistical analysis of patients' t(9; 22) with other factors revealed, significant association (p < 0.05) of t(9; 22) with patients outcome, age > 35 years, hepatosplenomegaly, absence of lymphadenopathy, TLC ≥ 50 × 10 9 /L, absolute PB blasts ≥ 4.4 × 10 9 /L, immunophenotyping and other aberrations. Conclusion: BCR/ABL fusion gene analysis by ES-FISH may serve as a prognostic marker in adulthood ALL. The age, TLC and t(9; 22) represent the significant standard prognostic factors in relation to patients' outcome.

Background. Acute lymphoblastic leukemia (ALL) is a malignant disease of the bone marrow in which early lymphoid precursors proliferate and replace the normal hematopoietic cells of the marrow. Philadelphia chromosome (Ph)-positive ALL, a high-risk cytogenetic subset, accounts for 25-30% of adult ALL cases but occurs in less than 5% of children. We aimed with this study to detect Ph chromosome in acute lymphoblastic leukemia patients, using (FISH), and to assess their relation with other standard prognostic factors and therapeutic response. Patients and methods. This study was carried out on 39 newly diagnosed ALL patients. All patients were subjected to; History, clinical examination and Laboratory investigations, which included CBC (Complete Blood Count), P.BL.(Peripheral Blood) smear and BM(Bone Marrow) examination, immunophenotyping and Fluorescence in situ hybridization to detect Ph chromosome. Results. This study was carried out on 39 newly diagnosed ALL patients show: Statistical analysis of patients' t(9;22) with other factors revealed significant association (p<0.05) of t(9;22) with patients outcome, age >35 years, hepatosplenomegaly, absence of lymphadenopathy, TLC ≥50X10 9 /L, absolute P.Bl blasts ≥4.4X10 9 /L and immunophenotyping. Conclusion. Ph chromosome expression serve as a powerful prognostic marker in adulthood ALL, As ph +ve adult acute lymphoblastic leukemia has poor prognosis and can be used as prognostic indicators for therapeutic response.