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Article
CD38 and ZAP-70 as prognostic immunological parameters in patients with chronic lymphocytic leukemia

Authors: Intisar Sh. Ali --- Ghassan A. Al-Anni --- Salman A. Al-Jubury
Journal: Iraq Joural of Hematology المجلة العراقية لامراض الدم ISSN: 20728069/25432702 Year: 2016 Volume: 5 Issue: 1 Pages: 90-97
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Several immunological parameters have been investigated in patients with chroniclymphocytic leukemia (CLL). Some of them are important in detecting the prognosis of thedisease.Objectives: the aim of this study was to evaluate the level of ZAP-70 and CD38 in patients withnewly diagnosed chronic lymphocytic leukemia.Materials and methods: The study was done on 50 patients with newly diagnosis CLL 36 maleand 14 female. CD38 and ZAP-70 were measured in patients by using flow cytometry. Thesepatients were divided according to Ria stage into 29 patients with group II, 21 patients with groupI, group I included Rai stage O, I, II in which the RBC and platelet counts are normal while groupII included Rai stage III and IV in which RBC and platelet count are low.Results: ZAP-70 and CD38 were significantly increased in patients with group II when comparedto group I. ZAP-70 and CD38 may be regarded as bad prognosis factor for CLL patients.Conclusion: From the results of the current study, we conclude that ZAP-70 and CD38high level in patients with chronic lymphocytic leukemia is associated with bad prognosis

Keywords

CD38 --- ZAP-70 --- CLL


Article
Flowcytometric Measurement of CD5, CD23, and CD38 expression as a diagnostic and prognostic markers in CLL patients

Authors: Alauldeen Mudhafar Zubair Alqasim --- Aseel Abdulameer Kareem
Journal: Iraq Joural of Hematology المجلة العراقية لامراض الدم ISSN: 20728069/25432702 Year: 2015 Volume: 4 Issue: 1 Pages: 16-38
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: B-Chronic lymphocytic leukemia (B-CLL) is a monoclonal malignancycharacterized by an accumulation of terminally differentiated small and anergic B lymphocytes inthe blood, bone marrow and other tissues. CLL is typically characterized by CD5+, CD23+,CD22 -, CD79b-, with weak expression of surface Ig. CD5 also is expressed in B1 subset ofhuman B –lymphocytes. Mature B cell malignancies, such as B-cell chronic lymphocyticleukemia, are mostly CD5 +. CD23 promotes the activation and proliferation of normal Blymphocytes and has an important role in the process of malignant transformation in BCLL.CD38 is expressed on the surface of leukemic cells in a significant percentage of patientswith B-cell chronic lymphocytic leukemia (B-CLL).Its expression has prognostic value in CLL.The current immunophynotype antigens is used to diagnosed as CLL cases, and by using themodern multicolor Flow Cytometry, which made it possible to determine the expression ofseveral such antigens on specific cell populations of the CLL cases.Objectives: To measure the expression of CD5, CD23, and CD38 antigens on the B-cells ofmorphologically diagnosed CLL cases, and showing their correlation with the hematologicalparameters, and with each other.Material and methods: A prospective cohort study including 20 patients including 11 femalesand 9 males morphologically diagnosed with CLL. The patients were attending the NationalCenter of Hematology, Al-Yarmouk teaching hospital for the period from November 2012 toMarch 2013. A total of 2 ml of venous blood were collected from all patients who were selectedrandomly with respect to age, sex, duration and stage of the disease. The diagnosis was done by measuring and calculating the total number of blood cells and lymphocytes and hemoglobin andother by using autoanalyzer blood counter, then flowcytometry was used to measure theappearance of antigens surface CD5 and CD23 CD38.Results: The mean of age of all patients included was 61.95+8.88 SD, and a range of (45-75)years old. There were 11 (55%) males patients, the most common symptoms of patients is anenlarged spleen (45%). 85% of patients who were in Binet stage C, the most advanced stage ofthe disease. Within Binet stage C there was 94.1% percent of patients showed moderate intensityexpression of CD5 and CD23, while 64.7% of them for CD38. There was no statisticalsignificance of CD5, CD23 in relationship to age, hemoglobin or platelet, while CD5 showed asignificant relationship with lymphocytes count and the total number of white blood cells (P<0.05).CD38 showed significant relationship with hemoglobin (P <0.05). There is a significantcorrelation between the CD5 and CD23 P) <0.05), while the CD38 show positive correlation withCD23) P <0.05.Conclusions1-There is a significant correlation between CD5 expression and absolute lymphocyte count, sohigher peripheral blood lymphocyte associated with greater CD5 antigen expression.2-There is a significant correlation between CD5, and CD23 expression, so high CD5 expressionassociated with high CD23 expression.3-There is a significant negative correlation between CD38 expression and Hb level thatreflects a prognostic significance.4-There is a correlation between CD38 expression and CD23 expression.5-No correlation between the intensity of expression of CD5, CD23, and CD38 and stage of thedisease.6-No correlation between CD38 expression and age, WBC count, and lymphocyte count


Article
Expressions of immunoglobulin M and immunoglobulin D heavy chain in B‑chronic lymphocytic leukemia and their correlation with CD38 expression

Authors: Ghid Nahd Abdul Muhssen --- Hind Shaker AL‑Mamoori --- Majid Hameed Ahmed
Journal: Iraq Joural of Hematology المجلة العراقية لامراض الدم ISSN: 20728069/25432702 Year: 2017 Volume: 6 Issue: 2 Pages: 55-59
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

BACKGROUND: B‑chronic lymphocytic leukemia (CLL) is a monoclonal malignancy characterizedby an accumulation of small mature‑looking B lymphocytes in the blood, bone marrow, and othertissues. It is typically characterized by CD5+, CD23+, CD22−, and CD79b−, with weak expressionof surface immunoglobulin (Ig).OBJECTIVES: The aim of the study was to assess the expression of IgM and IgD heavy chain byflow cytometry in untreated newly diagnosed B‑cell CLL and correlate the heavy chain isotopesexpression with CD38 expression.MATERIALS AND METHODS: A prospective cross‑sectional study was conducted on thirty patientswith new diagnosis of B‑CLL. The study was conducted at nursing home teaching laboratory inmedical city hospital in Baghdad for the period from November 2016 to March 2017. Five milliliter ofvenous blood in ethylenediaminetetraacetic acid was collected from thirty patients for detection ofexpression of IgM, IgD, and CD38 by flow cytometry. The patients were randomly selected regardingthe age, sex, and stage of the disease.RESULTS: The mean age of all included patients was (61.73 ± 6.92) with more disease predominantin male than female. The most common presenting feature of the patients was lymphadenopathyfound in 16 patients (43%). Regarding staging system, six (20%) patients were in with Binet Stage Cand five patients (17%) were in modified Rai Stage 4. CD38 and IgM expression showed a significantrelation to hemoglobin and platelets (P < 0.05). There was a significant positive correlation betweenIgM and CD38 while it was negative between IgD and CD38.CONCLUSIONS: The current study showed that the expression of CD38 had a significant correlationwith IgM expression as well as there was positive correlation with the stage of the disease whichmay point out to inferior prognosis for those patients with CLL.


Article
CD38 EXPRESSION ON PERIPHERAL T AND B LYMPHOCYTES IN NEWLY DIAGNOSED T1DM CHILDREN
الواسم السطحى (CD38) على سطوح الخلایا اللمفیة التائیة والبائیة في الاطفال حدیثي الاصابة بالسكري من النوع الاول

Authors: Nidhal Abdul Mohymen نضال عبد المهيمن محمد --- Eman M. Saleh ایمان مھدي صالح
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2008 Volume: 6 Issue: 3 Pages: 42-46
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background: In Type 1 Diabetes Mellitus (T1DM), numerous changes in the cellular as well humoral immune response have been identified. However, it is not known whether both the CD4+ and CD8+ subpopulation or onlyone of these or CD19+ contains increased numbers of activated cells.Objective: The aim was investigate the expression of CD38 as activated marker on the peripheral blood lymphocytes of T1DM children at the onset of the disease.Patients and methods: A total of 60 T1DM patients who were newly onset of the disease (diagnosed less than five months) were included in the present study, all the patients were treated with daily replacement doses of insulin. Fifty apparently healthy control subjects underwent the peripheral blood lymphocytes (PBL)phenotyping. Phenotyping of surface antigens was done by direct Immunoflurocent (IF)technique using mouse antihuman CD38.Results: Increased percentage of activation marker CD38+ cells were observed in T1DM patients (24.72%, 23.83%) as compared with the control group (16.86%, 15.97%) in the age group ≤10 years and >10 years old respectively. These differences were highly significant (P1=0.0001)between the patients and healthy individuals, but failed to reach a significant level (P2= 0.44)between the patients in both age groups.Conclusion: A significant elevated percentage of CD38+ activation marker cells were detected in the patients.

خلفية الدراسة: فى مرض السكرى من النوع الاول تحدث تغييرات فى كثير من الاستجابات الخلوية بالاضافة الى الدموية. ولا يعرف بالتحديد هل ان هذه التغييرات تحدث فى الخلايا الحاملة للواسم CD4 او الواسم CD8 او كلاهما او الحاملة للواسم CD19. هدف الدراسه: تهدف الدراسة الى التقصى عن تعبير الواسم CD38 على سطوح الخلايا اللمفية الفعالة فى الدم المحيطى للاطفال حديثى الاصابة بالسكرى من النوع الاول. المرضى وطريقة العمل: اجريتالدراسة على ستين (60) مريضاً حديثي الإصابة بمرض السكري النوع الأول (مشخصين بالإصابة خلال فترة أقل من خمسة أشهر)، تم اختيارهم من المركز الوطني للسكر / الجامعة المستنصرية. جميع المرضى هم تحت المعالجة اليومية بجرعات الانسولين وتمت المقارنة مع (50) شخص يبدون اصحاء كمجموعة سيطرة لغرض اجراء التشخيص المظهرى للواسمات السطحية للخلايا اللمفية بطريقة التالق المناعي المباشر وباستخدام الواسم السطحي CD38. النتائج: أظهر مرضى السكر من النوع الأول ارتفاعاً معنوياً ملحوظاً (p=0.0001)في عدد الخلايا اللمفية الموجبة للواسم الفعال CD38 (24.72% و 23.83) مقارنة بمجموعة السيطرة (16.86% و15.97) فى مجموعة الاعمار اقل من 10 سنوات واكثر من 10 سنوات بالتعاقب. ولكن هذه الزيادة لم تكن معنويةً للخلايا الموجبة للواسمة عند المقارنة بين مجاميع المرضى (p=0.4).الاستتاجات: هنك زيادة ملحوظة في نسبة الخلايا اللمفية المحيطية الحاملة للواسم الفعال CD38 في مرضى السكر من النوع الاول.مفاتيح الكلمات: مرض السكري من النوع الاول, الواسمة السطحية CD38, التشخيص المظهري المناعي.


Article
Immunohistochemical Expression of CD27 in Bone Marrow Biopsies of Chronic Lymphocytic Leukemia Patients

Authors: Taymaa M. Ahmed --- Abeer A. Ahmed
Journal: Iraqi Journal of Cancer and Medical Genetics المجلة العراقية للسرطان والوراثة الطبية ISSN: 20786123 Year: 2018 Volume: 11 Issue: 1 Pages: 24-33
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Chronic lymphocytic leukemia (CLL) is the most frequent lymphoproliferative disorder in western world. Its main characteristicis proliferation of mature looking lymphocytes in bone marrow, blood and lymphoid tissues. Diverse clinical course,ranging from indolent course to aggressive disease could be seen .So, many efforts focus on finding reliable indicators that canhelp to predict the outcome or explain CLL clinical variability.Certain surface proteins such as CD38, CD49d and ZAP-70 are expressed on leukemic cell population and they are widelyused as well-established prognosticators. Novel Markers such as CD27 has been emerged, but still there is controversy aboutits exact role in CLL prognosis.CD27 molecule is a member of the TNF receptor family, related to leukemic cells adherence to stromal cells, and to CLLprognostic factors.This study aimed to assess the immunohistochemichal expressions of CD27 in bone marrow biopsies of CLL patients andcorrelate it to the clinicopathological parameters.Methods:Cross sectional study was done on forty bone marrow paraffin blocks of untreated patients with CLL, collected from teachinglaboratories of Medical City and National Center of Hematology, from November 2016 to June 2018. Immunohistochemicalstaining for CD27, CD38 antibodies were studied in relation to clinicopathological details.Results:Positive result of CD27 was found in (77.5%) of cases, with moderate intensity in (87.1%), score (1) in (61.3%) of cases.CD27 was significantly associated with Binet stage C, Rai stage IV , Hb level less than 10 g/dl and diffuse bone marrow involvementwith ( P =0.021, 0.001, 0.018, and 0.001 respectively). No association could be established between CD27 and thewell-established CD38 in our study group.The sensitivity of CD27 was (100%) for CLL high risk patients (Binet stage C). Specificity = 33.3% and accuracy of CD27marker was 55%.Conclusions and recommendations:Immunohistochemistry can be used reliably to assess the expression of CD markers. Positive expression of CD27 in CLLcases significantly correlated with more advanced stage and CLL histological type of poor prognosis.We recommend further prospective studies to address if there is possible correlation between CD27 in CLL and chemosensitivityand other prognostic indicators.


Article
CD49d as Prognostic Marker in B-Cell Chronic Lymphocytic Leukemia in Correlation with the Expression of CD38, ZAP-70 and Clinical Binet Stage

Author: Haithem Ahmed Al-Rubaie*, Zahraa Akram Thabit**, Ali Mohammed Jawad***
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 4 Pages: 486-492
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Chronic lymphocytic leukemia (CLL) is a heterogeneous disease with highly variable clinical course and outcome. A number of clinical and biological features have been used to separate patients with CLL into subgroups with different prognoses. CD49d, CD38 and ZAP-70 expressions have shown to independently predict prognosis in CLL.OBJECTIVE: To assess the expression of CD49d in CLL patients and correlates them with CD38 and ZAP-70, and with clinical Binet staging.PATIENTS AND METHODS: This study was conducted on 30 newly diagnosed CLL patients. Diagnosis was based on lymphocyte count of > 5×109/L and immunophenotyping. The expression of CD49d, CD38 and ZAP-70 were investigated using four-color flow cytometer.RESULTS: The expression of CD49d, CD38 and ZAP-70 were detected in 60%, 56.7% and 30% of patients, respectively. The correlations between the expression of CD38 and both CD49d and ZAP-70 were both statistically significant (P= 0.002). A higher significant correlation was found between CD49d and ZAP-70 (P= 0.001). There was a statistically significant relationship between CD49d expression and Binet staging (P =0.035), while no significant relations were found between both CD38 and ZAP-70 and Binet staging (P >0.05). CD49d was more sensitive (76.5%) than the other two markers in prediction the intermediate and advanced stage with accuracy of 70%.CONCLUSION: CD49d expression was higher than that of CD38 and ZAP-70 and was significantly correlated with both of them. The adverse prognostic impact of CD49d was demonstrated by higher expression levels in intermediate and advanced-stage patients. CD49d has the highest sensitivity and accuracy with considerable specificity when compared with CD38 and ZAP-70, rendering CD49d a reliable biomarker for prognostication of CLL.

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