الفهرس 
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Abstract
B-Chronic lymphocytic leukemia (B-CLL) is a monoclonal disorder characterized by the accumulation of small mature-appearing CD5+ B lymphocytes in the blood, marrow, and lymphoid tissues.
Recent risk parameters were defined as prognostic markers that appear to be clearly related to the biology of B- CLL including defects detectable on fluorescence in situ hybridization, immunoglobulin heavy-chain variable region (IgVH) mutational status, surface markers CD38, CD 26 and intracytoplasmic ZAP-70 levels.
This work was conducted to evaluate the clinical value of CD49d, CD38 and CD26 as an independent prognostic factors for CLL, in relationship with other well-established prognostic factors of biologic relevance.
In our study 27 (54.0%) cases had high CD49d expression, 25 (50.0%) cases had high CD38 expression and 28 (56.0%) cases had high CD26 expression.
There were significant differences between high versus low expression of CD49d and CD26 regarding splengomegaly, between high versus low expression of CD49d and CD38 regarding hepatomegaly, Binet staging showed significant differences between high versus low expression of CD26, Rai staging showed significant differance in CD49d and CD26 expression.
High expression of CD49d and CD26 was associated with significant increase in TLC and peripheral blood mature lymphocytes, high expression of CD49d, CD38 and CD26 was associated with significant decrease in platelets count, high expression of CD38 and CD26 showed significant decrease in Hb level and high expression of CD49d, CD38 and CD26 was associated with significant increase in LDH .
High expression of CD49d, CD38 and CD26 correspond to each other, and low expression CD49d, CD38 and CD26 correspond to each other.
CD49d, CD38 and CD26 expression groups showed significantly higher progression to a more advanced stage, shorter time to develop lymphocytic doubling time and shorter treatment -free survival.
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Summary and Conclusion
In present study multivariate analysis showed that CD49dhigh, CD38high and CD26high are independent prognostic factors for developing lymphocytic doubling.
Also multivariate analysis showed that higher absolute lymphocytic count, LDH, CD49d, CD38 and CD26 are independent prognostic factors for treatment -free survival.