الفهرس 
ACUTE MYELOID LEUKEMIA
EpidemiologyOnly 14 pages are availabe for public view
 |  | from | 253 |  |  |
| | | from | 253 | | |
Abstract
Acute myeloid leukemia is a clonal disorder characterized by the rapid proliferation of abnormal cells which accumulate in the bone marrow interfering with the production of normal blood cells
Experimental and clinical evidence indicate that bone marrow cells participate in the process of new blood vessel formation. However, the molecular mechanisms underlying their recruitment and their exact role are still elusive. Bone marrow cells are recruited to the sites of neoangiogenesis through the neuropilin-1(NP-1) receptor and that they are essential for the maturation of the activated endothelium and the formation of arteries . The 165-aa isoform of VEGF, which both activates the endothelium and recruits NRP-1 myeloid cells, is a powerful arteriogenic agent.
The aim of this study was evaluate the significance of neuropilin-1 expression at diagnosis in acute myeloid leukemia patients by studying its expression and correlating this expression with other prognostic factors in such patients.
This study was conducted on 22 newly diagnosed AML and 6 relapsed AML patients, 12 males and 16 females with a male to female ratio 1.0: 1.3, their ages ranged from 19 - 70 with a mean of 40.64 ± 13.91.
All patients subjected to clinical examination laying stress on the presence of organomegaly, lymphadenopathy, bleeding per orifices and CNS manifestations, Complete blood picture and Leishman stained blood films, bone marrow aspiration and examination for patients only, Immunophenotyping using panel of acute leukemia for diagnosis of AML patients only, Neuropilin-1 expression by flow cytometry and quantitative real time PCR analysis.
Results of this study suggested that there was a highly significant difference as regards neuropilin-1 surface expression by flow cytometry both as percent positivity or its MFI comparing control group to AML patients groups (either taking patients as a whole or after categorizing patients into denovo and relapsed groups).
A diagnostic cut off level of neuropilin-1 % expression was detected in this study, discriminating AML patients group from healthy control group and this level was found to be 6% of cells expressing neuropilin-1 surface antigen.
In denovo AML patients, a highly significant positive correlation was found between NRP-1% expression and TLC and a negative one with Hb level. However, no significant correlation found between NRP-1% expression and any other parameters; age, platelet count, LDH, peripheral blood blast(%), CD33, CD13, CD14, CD117, CD61, myeloperoxidase, CD2, CD5, CD7, CD34, HLA-DR, CD10 and survival time.
Relapsed AML patients, showed a positive highly significant correlation between NRP-1% expression and age and another positive one with each of BM blast % and CD14, however, as for other parameters as TLC, Hb, platelet count, peripheral blood blast(%), LDH, CD33, CD13, CD117, CD61, myeloperoxidase, CD2, CD5, CD7, CD34, HLA-DR and CD10 no significant correlation was found.
No statistical significant difference was found comparing NRP-1 RNA level in patients and control group either comparing patients as a whole or dividing patients into two groups; denovo and relapsed patient groups.
In denovo AML patients group, a positive highly significant correlation was found between NRP-1 RNA and TLC, another positive one was found with Pb blast% and CD117 but negative significant correlation was detected with Hb, however, there was no significant correlation between NRP-1 RNA and age, platelet, LDH, BM blast %, CD33, CD13, CD14, CD61, myeloperoxidase, CD2, CD7, CD34, HLA-DR, CD10 and survival time.
A positive significant correlation between NRP-1 RNA and LDH was detected in relapsed AML patients group with no other significant correlation between it and any other parameters; age, TLC, Hb, platelet, PB blast%, BM blast%, CD33, CD13, CD14, CD117, myeloperoxidase, CD2, CD5, CD7, CD34, HLA-DR and CD10. A negative significant correlation between NRP-1 RNA was found between NRP-1 RNA level and CD61.
In conclusion, the evaluation of NRP-1 by flow cytometry can be used as a diagnostic tool for acute myeloid leukemia depending on its cut off level. Also, NRP-1 assessment in patients with acute myeloid leukemia can be used as a predictor prognostic marker by both flow cytometry and real time PCR.
/