الفهرس 
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Abstract
Chronic lymphocytic leukemia (CLL) is a chronic lymphoproliferativemalignancy characterizedby progressive lymphocytosiscausedby theclonalaccumulationsofCD5+,CD19+ B-Cellsinperipheralblood,bone marrowandlymphoidorgans.
The clinicalstagingsystemsare themostpowerfulmethodsfor predicting survivalinCLL, howeverthesemethodsareunableto predictdiseaseprogressionintheearly stages,forthesereasons severalparametershave beenaddedto the current staging systemsto different prognostic subsetsincludingage, sex, lymphocyte morphology andnumber,lymphocytedoublingtime(LDT),serum factors,and,recentlyimmunophenotypingandcytogenetic findings.
CD39isasurfacemarkerfoundtobepresentinmany cancers. HydrolysisofATPbyCD39,utilizingitsectonucleaseactivity seems toplay acrucialrole intumor-associatedimmunesuppressionasthis removes proinflammatory ATP from the tumor microenvironment andalso generatesadenosinewhichmediatesthe inhibition of Tcell proliferation, thus CD39 is proposed to be involved in the pathogenesisof CLL.
Theaim ofthisstudywastoassessCD3/39expressiononCLL patientsanditsrelationtotheclinicalandlaboratory parameters,and toevaluate itsprognostic impactonpatients.
Thecurrentstudywascarriedoutonthirtynewlydiagnosed CLLpatients,inadditionto10normalsubjectswhoservedasa controlgroup.Usingflowcytometry,the studiedcaseswere investigatedfor CD3/39expressionwhichwasexpressedas percentage.Patients wereclinically evaluatedlayingstressonthe presence orabsenceof hepatomegally,splenomegaly,and lymphadenopathy,inadditiontolaboratory assessmentandstaging systems(RaiandBinet).SurfaceCD3/39wasassessedwhere itwas foundtobesignificantly increasedinthe peripheralbloodofpatients withCLLandcorrelatedwiththe advanced stageof disease.
This study demonstrated highsignificant elevation inTLC, absolute lymphocyticcount,and;lowHblevelandplateletcount in CLLpatientscomparedtothe controlgroup.
Increased expression of the CD3+CD39+ cell population in CLLpatientswasfoundtobe significantly higherinpatientswith advancedRai andBinetstagingcompared toanearly-stage disease.
Statistically,therewasnosignificantassociationbetween T- lymphocyte CD39andCD38status.
Inthe present study,significantassociation between highCD38 expressionsamongadvancedRaiandBinetstage patientswasfound.
Asregardsorganinfiltration, the presentstudy demonstrated significantpositive correlationbetweenCD3/39expressioninCLL patientsandthe presenceof bothsplenomegalyandhepatomegally.
Fromthisstudywe concludedthat:
- CD39wasexpressedonagreaterpercentageofT-lymphocytesfrom
patientswithCLLthanfromnormalcontrol.
- T-lymphocyte CD39expressionwaslowerinpatientswithearlystage of disease thanadvancedstage.
- T-lymphocyteCD39expressionmaybeusefulprognosticmarkerin patientswithCLL.