الفهرس 
Introduction and Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
CD40 positive expression may be a good prognostic factor in ALL,AML,CML (Chung and Lim,2014).
Detection of CD40 expression at diagnosis is of high clinical relevance, because its expression has a direct cosequence for treatment stratification, being associated with good prognosis (Hock et al.,2006).
The present study aimed to assess CD40 expression frequency in patients with ALL, AML, CML and to evaluate its association with the different demographic, clinical and laboratory data as well as its relation to disease outcome.
All patients were subjected to complete history taking, thorough clinical examination and laboratory investigations including : complete CBC, bone marrow aspiration with examination of Leishman-stained peripheral blood and bone marrow smears, immunophenotyping and detection of the level of CD40 expression by flowcytometry.
No statistically significant associations were elicited between CD40 expression and any of the studied prognostic factors of patients. Howeve, a significant positive association was detected between patients who responded to chemotherapy and positive CD40L. So CD40L could be regarded as an independent good prognostic factor for the prediction of good response to chemotherapy.
Concerning the clinical outcome of the studied patients, CD40 negative patients showed more incidence of resistance to chemotherapy and death than CD40L positive patients, while CD40L positive patients were more liable to achieve complete remission.
Moreover, there was a highly statistically significant associations between CD40 expression and with a longer OST and DFS so CD40 could be regarded as an independent prognostic parameter for relapse free survival.
we conclude that CD40L is an independent prognostic factor for relapse free survival,and also an independent prognostic factor for the prediction of good response to chemotherapy, since CD40L positive patients are more liable to achieve complete remission, while CD40 negative ones are more susceptible to death or chemotherapeutic resistance.