الفهرس 
Prognostic Factors of All
Clinical and Laboratory Features at DiagnosisOnly 14 pages are availabe for public view
 |  | from | 162 |  |  |
| | | from | 162 | | |
Abstract
Acute lymphoblastic leukemia (ALL) is a malignant
disorder of lymphoid progenitor cells that proliferate and
replace the normal hematopoietic cells of the bone marrow.
These lymphoblasts replacing the normal bone marrow
elements result in a marked decrease in the production of
normal blood cells.
It is the most common malignancy diagnosed in
patients younger than 15 years, accounting for 76% of all
leukemias in this age group. It accounts for only 20% of
adult acute leukemias.
There are many prognostic factors in ALL such as
age, sex, race, leukemic burden, laboratory criteria (initial
TLC, hemoglobin level, platelet count and serum
immunoglobulins), immunophenotyping, chromosomal
abnormalities, duration to induction of remission, drug
resistance profiles, and minimal residual disease.
Assessment of these factors is mandatory for therapeutic
assignment.
The B7-family molecule CD86 is a type I
transmembrane glycoprotein expressed on the surface of
antigen presenting cells (APCs). Cell surface expression of CD86 (mCD86) provides an important co-stimulatory signal
which profoundly influences immune responses. Optimal Tcell
activation needs costimulatory signals via the interaction
between costimulatory molecule CD28 on T lymphocytes and
its ligands the B7-family molecules B7.2 (CD86) on APCs.
This leads to their proliferation, cytokine production, and
development of effector functions. Activation and
differentiation of T lymphocytes plays an important role in
mediating the pathogenesis of ALL.
The present study aimed to evaluate the usefulness of
CD86 expression in the diagnosis and characterization of
ALL and to study its prognostic impact.
The current study was carried out on 35 newly
diagnosed childhood and adults ALL patients.
The studied patients were subjected to complete
history taking, clinical examination, complete blood picture
(CBC), bone marrow (BM) aspiration and flow cytometry
(FCM) immunophenotyping by Coulter (Epics-XL) FCM
using the routine panel for acute leukemia. The CD86
expression was also detected by FCM.
In this work, all ALL patients showed positive
expression of CD86, which gives impression that CD86
may play a role in molecular pathogenesis of the disease.Our study revealed significant statistical difference between
patients’ group and control group regarding CD86
expression percentage and MFI.
On analyzing the relationship of CD86 percentage
expression with various studied standard prognostic factors,
a non-significant association was found between it and any
standard clinical and laboratory prognostic marker.
Follow up of all patients showed that there was a
non-significant association between patients’ outcome and
age, clinical or laboratory data. On the other hand, a high
significant association was found between CD86% and
MFI expression and patients’ outcome.
In Conclusion, High CD86% and MFI expression
appears to be a powerful prognostic indicator of
unfavorable outcome in childhood and adulthood ALL.
Analysis of CD86 percentage and MFI expression in
addition to other standard prognostic markers at diagnosis
may contribute to improve the management of ALL
patients. Further studies will be needed to verify these
results and provide more statistical power to our
observations.