الفهرس 
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Abstract
A
cute myeloid leukemia (AML) is a clonal hematopoietic stem cell disorder, characterized by arrested differentiation, inappropriate proliferation and survival of immature myeloid progenitors. The AML has the lowest survival rate of all leukemias, so, assessment of the prognostic factors in AML is very important.
This work aimed to determine the influence of immune-phenotypic maturity, via application of the flow cyto-metric maturity score based on quantitative expression of the three markers of maturity; CD34, CD117, TdT with a score from 0 to 5, on laboratory parameters, clinical outcome and survival of patients with acute myeloid leukemia within the different cytogenetic risk groups.
The current study was carried out on 40 newly-diagnosed AML patients at Ain Shams University Hospital. All patients were subjected to complete history taking, thorough clinical examination and laboratory investigation including: complete blood picture, bone marrow aspiration with examination of Leishman-stained peripheral blood and bone marrow smears, immuno-phenotyping and obtaining cytogenetic results.
Maturity score was applied to all of the studied AML patients, dividing them into mature (with a score ranging from 0 to 1) and immature (with a score ranging from 1.5 to 5) groups. Kaplan-Meier curve showed that mature group had higher survival with mean of 3.613 and confidence interval of 1.947-5.278 than the immature group that had a lower survival with mean of 2.778 and confidence interval of 2.216-3.674.
In our study, we found no statistically significant difference when comparing mature and immature groups regarding clinical data, routine laboratory data, FAB subtypes and groups, cytogenetic abnormalities with ELN prognostic groups, clinical outcome at day 28 and 6th month or survival.
Also there was no statistically significant difference when comparing patients in CR/iCR versus PR/dead regarding different variables at day 28 and at 6th month.
In addition, statistical studies showed no correlation between expression of each of the maturity score markers individually and clinical outcome (at day 28 and at 6th month) or survival (OS and DFS).
In conclusion, our results despite showing higher survival in mature than immature groups, did not prove the prognostic value of maturity score as a tool of risk stratification of AML patients. However, further evaluation of the maturity score in a larger AML cohort in order to assess its role as a provisional timely and cost effective prognostic tool in under-resourced areas where cytogenetic and molecular studies are unaffordable.