الفهرس 
ACUTE LYMPHOBLASTIIC LEUKEMIIAOnly 14 pages are availabe for public view
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.
There are many prognostic factors in ALL such as age,
sex, race, leukemic burden, laboratory criteria (initial TLC,
hemoglobin level, platelet count, immunophenotyping and
chromosomal abnormalities). Assessment of these factors is
mandatory for therapeutic assignment.
CD27 is a member of the tumor necrosis factor family, is
expressed on T cells, Nk cells and memory B cells. The
interaction between CD27 and its ligand CD70 plays an
important role in in the maturation and activation of these cells.
It plays an important role in lymphoid differentiation and
apoptosis, induced on normal B lymphocytes after antigenic
challenge it is a marker of memory B cells.
Increased levels of sCD27 have been associated with
immune activation in diseases such as AIDS, multiple sclerosis
and systemic lupus erythromatosus The present study aimed to assess CD27 expression
frequency in patients with ALL, and to evaluate its association
with the different demographic, clinical and laboratory data, as
well as its relation to response to therapy.
The current study was carried out on 30 newly diagnosed
ALL patients & 20 healthy control. All patients were subjected
to complete history taking, thorough clinical examination and
laboratory investigations including: complete hemogram, bone
marrow aspiration with examination of Leishman-stained
peripheral blood and bone marrow smears, immunophenotyping
and detection of the level of CD27 expression by
flowcytometry.
CD27 expression was not associated with any of the
studied demographic or clinical data but was associated with
some laboratory variables.
Sstatistically significant associations were elicited
between CD27 expression and some of the studied prognostic
factors of patients. In addition, a significant positive association
was detected between patients who responded to chemotherapy
and positive CD27 expression. So, CD27 could be regarded as a
good prognostic factor for the prediction of good response to
chemotherapy. Concerning the clinical outcome of the studied patients,
CD27 negative patients showed more incidence of resistance to
chemotherapy than CD27 positive patients.
Detection of CD27 expression at diagnosis is of high
clinical relevance, because its expression has a direct
consequence for treatment stratification, being associated with
good prognosis.
Finally, these findings imply that CD27 positive
expression confers good prognosis in ALL patients.
from this study, we conclude that CD27 is a good
prognostic factor, and also for the prediction of good response
to chemotherapy, since CD27 positive patients are more liable
to achieve good response to therapy, while CD27 negative ones
are more susceptible to chemotherapeutic resistance.