Acute Leukemia Clinical Trial
Official title:
Expression of Aberrant CD Markers in Acute Leukemia:Retrospective Study in South Egypt Cancer Institute
- To determine incidence of Expression of aberrant CD markers in acute leukemia in South
Egypt .
- Correlation between this expression and outcome of the patient.
"Acute leukemia" is defined by the World Health organization standards, in which greater than
20% of the cells in the bone marrow are blasts (Kabuto et al., 2006).
Acute leukemia is a cloned expansion of tumor cells in bone marrow, blood or other tissues.
The acute leukemia is classified as acute myeloid leukemia (AML) due to defective
differentiation of myeloid lineage or acute lymphoid leukemia (ALL) due to defective
differentiation of lymphoid lineage(Olaniyi JA et al., 2011).
Leukemia is diagnosed by morphology and cytochemical examination of blast cells,
immunophenotyping, cytogenetic and molecular genetics. (Hazarika M et al., 2015 ).
immunophenotyping is mandatory for the diagnosis of hematolymphoid malignancies (Craig FE et
al., 2008)
Immunophenotyping of leukemia cells plays crucial role in identification of leukemia cell
line, assesment of maturation stage and finding possible aberrant antigens which in turn
serves for individual treatment monitoring and detection of residual disease(Kahng J et
al.,2008).
Immunophenotyping identifies cell surface/CD markers(cluster of differentiation), expressed
at different stages of cell development, by applying monoclonal antibodies against them helps
in the diagnosis and classification of leukemia. The morphologically similar blast cells can
be easily differentiated by immunophenotyping on the basis of expression and different CD
markers (Angelescu S et al.,2012).
Aberrant expression of CD markers has been observed in several cases of acute leukemia(Chang
Y et al., 2011).
Aberrant phenotype is a phenomenon in which lymphoid-associated and other myeloid lineage
markers expressed in myeloblasts or myeloid-associated markers expressed in lymphoblasts.
Aberrant phenotype incidence has been reported in both ALL and AML with varying frequencies
as high as 88%(Macedo A et al.,1995).
The aberrant phenotypes are classified into different types: co-expression of
lymphoid-associated antigens or lineage infidelity; asynchronous antigen expression, in which
early antigens are coexpressed with more mature ones; or antigen overexpression and existence
of abnormal light scatter patterns(Gert Ossenkoppele et al., 2011).
Presence or absence of these aberrant markers may also be associated with poor or favorable
prognosis(Alhan C et al., 2014).
Several studies have reported correlations of aberrantly expressed markers with clinical
outcome in AML. For example, CD7 and CD25 expression has been associated with poor prognosis
in normal karyotype AML(Cerny J et al.,2013) The IL3 receptor alfa (CD123) is overexpressed
in 45% of AML patients, and this higher expression has also been associated with poor outcome
(Riccioni R et al.,2002).
CD13 and CD33 are most frequently associated with aberrant myeloid expression in ALL (Hrusák
O et al,2002).Studies indicate that aberrant immunophenotypic expression can decrease the
time of remission and survival in children with ALL (Kurec et al., 1991).Aberrant expression
of CD13 in ≥ 5% of blasts of adult patients with ALL is an adverse prognostic factor,that
should be considered for more aggressive treatment(Dalal BI1 et al.,2014).
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