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Article
Evaluation of CD69 as a prognostic factor and its relation with other prognosticatos in a sample of Iraqi patients with chronic lymphocytic leukemia

Author: Maysem Mouayad Alwash
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2016 Volume: 15 Issue: 2 Pages: 69-74
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Chronic lymphocytic leukeamia (CLL) is clinically heterogenous disease with variable prognosis . It is important to take into consideration the prognosis of presenting with CLL before starting suitable therapeutic option. Different studies proved that leukemic CLL cells have the surface membrane phenotype of activated and antigen experienced B lymphocytes with the overexpression of the activation markers such as CD69 . In one previous study, CD69 was assumed to be considered as a new promising immunologic prognostic factor in B-CLL. Aim: In this study we aimed to detect CD69 expression in newly diagnosed patients with CLL by flow cytometry and correlate it with some other clinical and laboratory parameters in order to evaluate its role as a prognostic factor. Patients and Methods: CD69 expression was investigated by flow cytometry in 26 untreated newly diagnosed patients with chronic lymphocytic leukaemia ,and compared this with other standard prognostic parameters (β2- microglobulin , lymphocyte count , Rai stage and CD38 ). Results: The present study shows that about (34. 61% )of the CLL patient were positive for CD69 expression , while (65,38%) of patient were negative. CD69 expression is significantly associated with CD38 (P-0.002), Rai stages (p-0.0001) , lymphocyte count(p-0.0001) , β2-microglobulin (P-0.012). Conclusion: The results of this study demonstrated that CD69 is significantly associated with poor prognostic factors . This supports its introduction in a laboratory assessment of newly diagnosed patient with CLL and, possibly, in a prognostic scoring system for chronic lymphocytic leukemia.


Article
Immunohistochemical analysis of CD34 to evaluate angiogenesis in chronic lymphocytic leukemia
التعبير المناعي النسيجي الكيميائي للدالة CD34 لتثمين تكوين الاوعية الدموية الدقيقة في ابيضاض الدم اللمفاوي المزمن

Author: Shaymaa M. Abdelateef شيماء محمد عبد اللطيف
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2013 Volume: 55 Issue: 2 Pages: 131-134
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Chronic lymphocytic leukemia (CLL) results from a progressive accumulation of long-lived, functionally incompetent, nonproliferating lymphocytes.Angiogenesis is defined as the formation of new capillaries from pre-existing blood vessels and plays an important role in the progression of solid tumors as well as several hematologic malignancies like CLL.Patients and methods: A retrospective cross-sectional study done on 68 patients with CLL compared with 15 control individuals (anemic patients), all recruited at the Medical City Teaching Laboratories from January 2005 to December 2008. The bone marrow biopsy (BMB) of each was re-examined histologically. Immunohistochemical (IHC) technique was performed on BMB sections utilizing monoclonal mouse CD34 class II antibody. Results: This study revealed higher microvessel density (MVD) in BM of CLL patients than normal control marrows. CLL patients had a mean MVD of 10.78 VS 4.26 miorovessel count/high power field (MVC/HPF) in control subjects. Significant inverse correlation was found between MVD and PCV levels and platelet count. A Significant positive correlation was found between MVD and the percentage of lymphocytes in the bone marrow, BM infiltration pattern and the modified Rai stage of CLL patients Conclusions: Angiogenesis in CLL BM was significantly higher than control marrows and was more accentuated with advanced clinical stage of the disease.Key words: Chronic lymphocytic leukemia; CD34; IHC

الخلفية : ابيضاض الدم اللمفاوي المزمن ينتج من التجمع التراكمي للخلايا اللمفاوية طويلة العمر والتي وظيفيا غير فعالة و غير قابلة للانقسام. تكوين الاوعية الدموية الدقيقة هو تكون الشعيرات الدموية الجديدة من اوعية دموية سابقة و يلعب دوراً مهما في تقدم الاورام الصلبة وكذلك العديد من الاورام الدموية مثل ابيضاض الدم اللمفاوي المزمن.الهدف من الدراسة: تقييم تكوين الاوعية الدموية الدقيقة في ابيضاض الدم اللمفاوي المزمن وذلك بحساب كثافة الاوعية الدموية الدقيقة باستخدام الدالة CD34.اعداد و طرائق العمل: شملت هذه الدراسة التراجعية ثمان وستون حالة من ابيضاض الدم اللمفاوي المزمن (48 ذكر و 20 انثى). كانت لديهم خزع لنقي العظم اجريت اجريت في المختبرات التعليمية في مدينة الطب مابين الفترة من كانون الثاني2005 الى كانون الاول 2008 كذلك تم دراسة مجموعة ضابطة (العدد 15 حالة).تم استخدام التقنية المناعية النسيجية الكيميائية للكشف عن CD34 في خزع نقي عظم الحالات المرضية والمجموعة الضابطة. النتائج :- كان معدل كثافة الاوعية الدموية لابيضاض الدم اللمفاوي المزمن 10.78 والذي كان اعلى من معدل كثافة الاوعية الدموية الدقيقة للمجموعة الضابطة والذي كان 4.26 . (هذا الفرق معتد به احصائيا") كما وجدت علاقة عكسية ومعتدة بين زيادة كثافة الاوعية الدموية الدقيقة و كلا من مستوى حجم الخلية المحشو و عدد الصفيحات.هناك علاقة موجبة و معتدة احصائيا بين كثافة الاوعية الدموية و كلا من النسبة المئوية للخلايا اللمفاوية في نقي العظم, طراز ارتشاح نقي العظم وتقدم مرحلة المرض. الاستنتاجات :-1.تكون الاوعية الدموية الدقيقة في نقي عظم المرضى اعلى من المجموعة الضابطة.2.وجدت علاقة موجبة و معتدة احصائيا بين زيادة تكون الاوعية الدموية الدقيقة و مرحلة عالية الخطورة للمرض. 5. الدالة ٣٤- التعبير المناعي النسيجي - ابيضاض الدم اللمفاوي


Article
mRNA in situ hybridization analysis of VEGF in chronic lymphocytic leukemia

Authors: Haythem A. MJ Al-Rubaie --- Ban A. Abdul Majeed بان عباس عبد المجيد --- Abdulkareem M. Jaafar
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2011 Volume: 53 Issue: 2 Pages: 186-189
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Several factors render chronic lymphocytic leukemia (CLL) an interesting subject for study by researchers. These include marked progress in understanding the molecular biology of normal and neoplastic lymphocytes and recent advances in molecular genetics techniques. Among molecular markers, vascular endothelial growth factor (VEGF), have been widely studied.Objective: The aim of the study is to evaluate the role of VEGF in the pathogenesis of CLL and its role in disease progression.
Patients, materials and methods: A retrospective cross-sectional study was done on 60 patients with chronic lymphocytic leukemia (45 males & 15 females) compared with 20 controls (anemic patients), all recruited at the Medical City Hospital/ Teaching Laboratories/ Baghdad from January 2004 to December 2007. The bone marrow biopsy of each was re-examined histologically. In situ hybridization was performed utilizing biotin labeled VEGF cDNA probes.
Results: The frequency of VEGF positivity was 95% (57 of 60 cases). A statistically significant inverse correlation was found between increasing VEGF scores and lower packed cell volume level and lower platelet count. A statistically significant association was found between advanced modified Rai stage and patients with high score. In addition, there was a statistically significant positive correlation between increasing scores of VEGF and advancing clinical stage.
Conclusions: The score of VEGF is high among patients with advanced clinical stage of the disease.


Article
Efficacy of combination of rituximab therapy with chlorambucil plus prednisolone (R-LP) Protocol as treatment line in chronic lymphocytic leukemia patients

Author: Waseem F. Al Tameemi
Journal: Iraq Joural of Hematology المجلة العراقية لامراض الدم ISSN: 20728069/25432702 Year: 2015 Volume: 4 Issue: 1 Pages: 1-15
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Chronic lymphocytic leukemia (CLL) remains an incurable disease withvariable course. It is typically responsive to several courses of chemotherapy.Objectives: Evaluation of efficacy of combination of rituximab with chlorambucil plusprednisolone (R-LP) as first line of treatment of CLL patients whom are not fit for treatmentwith fludarabine combination therapy.Patients & Method: Over 17 months duration, thirty patients with CLL were included in thisa cohort prospective study. All of them were received 8 cycles combinations of rituximab(day 1) plus chlorambucil plus predinsolon (day1 to day 5). It had been used for thosecouldn’t receive or those having intolerance to fludarabin based therapy. At end of courses ,re-assessment had performed & included clinical examination ,blood count in addition to BMexamination for evaluation of response in term of overall response rate(ORR) ,duration ofresponse(DOR), and treatment free interval(TFI).Results: Overall response rate (ORR) reported in 86.67% of patients. Both anemia &bonemarrow lymphocyte percentage has significant relation to the treatment response (p=0.051,p=0.036 respectively) as well as positive direct antiglobulin test( DAT) & diffuse BMinfiltration (p=0.033,p=0.04 respectively). Mean duration of response (DOR) is 9.23+0.50months while mean treatment free interval (TFI) is 11.74+0.64 months. Bone marrowlymphocyte proportion is consistently predictive factor in long term remission durability innegative correlation( r = – 0.47, p= 0.04).Conclusion: Rituximab plus chlorambucil and predinsolon (R-LP) combination therapymight be as good alternative regimen with equivalent response for CLL patients whom arenonsuitable for treatment with fludarabine combination therapy


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
mRNA in situ hybridization analysis of p-53 cancer suppression gene and Bcl-2 oncogene in chronic lymphocytic leukemia

Authors: Saad A. Mustafa --- Haythem A. Al-Rubaie --- Abdulkareem M. Jaafar
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 2 Pages: 177-181
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Several factors render chronic lymphocytic leukemia (CLL) an interesting subject for study by researchers. These include marked progress in understanding the molecular biology of normal and neoplastic lymphocytes and recent advances in molecular genetics techniques. Among molecular markers, p53 cancer suppressor gene and the antiapoptotic gene Bcl-2 have been widely studied. Patients and methods: A retrospective cross-sectional study done on 60 patients with chronic lymphocytic leukemia compared with 20 controls (anemic patients), all recruited at the Medical City Teaching Hospital laboratories from January 2004 to December 2007. The bone marrow biopsy of each was re-examined histologically. In situ hybridization was performed utilizing biotin labeled p53 and Bcl-2 cDNA probes.
Results: The frequency of p53 positive signals in the study group was 28.3% (17of 60 cases). A significantly larger number of patients, with high score for p53 signal, were associated with high-risk clinical stage than patients with low score (p = 0.005). There was a significant direct positive correlation between increasing scores of p53-positive chronic lymphocytic leukemia cells and advancing clinical stage of the disease (p =0.002).
The frequency of Bcl-2 positivity was 50% (30 of 60 cases). No significant correlations found between Bcl-2 scores and clinical stage of the disease.
Conclusion: Although p53 alteration may occur early in the course of the disease, as shown by the p53 positivity in a proportion of patients in low and intermediate-risk stage of the disease, the highest frequency p53-positive cells, has been observed in high-risk stage of the disease. Therefore, p-53 score is an important prognostic variable in patients with chronic lymphocytic leukemia. However, Bcl-2, as assessed by ISH, is not regarded as an important prognostic marker.


Article
Assessment of Interleukin-8 in Patients with Chronic Lymphocytic Leukemia in Correlation with the Prognostic Factors: β2-microglobulin, LDH and Binet Stage

Author: Haithem Ahmed AL-Rubaie*, Safaa Jasim Mohammed**
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2018 Volume: 17 Issue: 2 Pages: 131-136
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Chronic lymphocytic leukemia is a malignancy of mature B cells characterized by progressive lymphocytosis, lymphadenopathy, splenomegaly, and cytopenia. The progressive accumulation of leukemic cells is a consequence of defective apoptosis and survival signals derived from the microenvironment.OBJECTIVE: Is to assess the levels of interleukin-8, 2-microglobulin and lactate dehydrogenase in chronic lymphocytic leukemia patients and evaluate the prognostic value of interleukin-8 in correlation with 2-microglobulin, lactate dehydrogenase and Binet stage.PATIENTS AND METHODS: A case-control study enrolled 40 newly diagnosed chronic lymphocytic leukemia patients attended at Oncology Teaching Hospital, Medical City with 40 adult healthy volunteers as a control group. Interleukin-8, 2-microglobulin and lactate dehydrogenase were investigated. RESULTS: There were statistically significant relationships between Binet staging and each of following: plasma level of interleukin-8, serum level of 2-microglobulin and lactate dehydrogenase and (P= 0.005, 0.005 and 0.023, respectively). There were significant correlations between 2-microglobulin and both interleukin-8 and lactate dehydrogenase level (P= 0.005, both) but correlation between interleukin-8 and lactate dehydrogenase was insignificant.CONCLUSION: Interleukin-8 level was positively correlated with 2-microglobulin, and higher plasma levels were associated with advancing Binet stage which makes it a reliable marker for patients at late clinical stage.


Article
Interleukin-6 Level among Iraqi Patients with Chronic Lymphocytic Leukemia from Babil Province

Author: Najlaa B. Alawadi
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2016 Volume: 12 Issue: 21 Pages: 112-123
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

Introduction: Interleukin-6 (IL-6) is a pro-inflammatory cytokine and an anti-inflammatory myokine. Chronic lymphocytic leukemia (CLL) is the most common type of leukemia in adults. The exact role of IL-6 in CLL is still contraversial and needs alot of research.Aim of the study: To measure serum level of interleukin-6 among Iraqi patients from Babil province with a newly diagnosed untreated chronic lymphocytic leukemia and to assess it's association with the stage of the disease and peripheral blood indices.Materials and methods: This is a case-control study included 106 Iraqi patients with a newly diagnosed untreated chronic lymphocytic leukemia (CLL). They were from Babil province and attended the hospital during the period from 1st of November 2012 to 30th of October 2015, while the control group included 106 age and sex matched healthy individuals. CBC, blood film and serum IL-6 (Human IL-6 ELISA kit ) were done for both groups, and bone marrow exam was performed for the patients only.Results: The age of the patients ranged from 44 to 82 years with mean age of 61.8 ±6.14 years. Male:Female ratio was 1.8:1 and 57.5% of them were asymptomatic. Serum IL-6 was undetected in 39.6% (42/106) of the control cases and in 13.2% (14/106) of the patients; all of them were in CLL stages 0 and 1. Mean serum IL-6 in the patient group was 12.6 ±5.1 pg/ml, while it was 6.2 ±2.3 pg/ml in the control group (P-value was 0.001). Higher levels were documented in stages 3 and 4 (P-value 0.0001). Conclusion and recommendations: Elevated serum IL-6 was found among Iraqi patients with newly diagnosed untreated CLL, and higher levels were documented in advanced stage disease. Further studies are needed to assess exact role of IL-6 in CLL as it may have prognostic and/or therapeutic implications.

مرض إبيضاض الدم اللمفاوي المزمن هو أحد أكثر أنواع إبيضاض الدم إنتشارا بين البالغين. يصيب هذا المرض الخلايا اللمفاوية من النوع (ب) مما يؤثر على انتاج ووظيفة العديد من العوامل المناعية في الجسم . يعتبر عامل الانترلوكين واحد من أهم هذه العوامل ومما يزيد في أهميتة هو غموض دوره في التأثير على هذا المرض.الهدف من الدراسة: قياس مستوى الانترلوكين-6 لدى المرضى العراقيين من محافظة بابل والمشخصين حديثا بمرض إبيضاض الدم اللمفاوي المزمن والذين لم تتم معالجتهم لحد لحظة إنضمامهم الى الدراسة.المرضى وطرق البحث: لقد شملت هذه الدراسة 106 من مرضى إبيضاض الدم اللمفاوي المزمن المشخصين حديثا وقبل تلقيهم للعلاج المتخصص والذين راجعوا مستشفيات محافظة بابل خلال الفترة الممتدة من الأول من تشرين الثاني 2012 ولغاية الثلاثين من تشرين الأول 2015. وشملت أيضا 106 من الأشخاص الطبيعيين كحالات سيطرة متوافقين بالعمر والجنس مع مجموعة المرضى. تم اجراء فحص صورة الدم ومستوى الانترلوكين-6 بالدم لكلا المجموعتين مضافا لها فحص نخاع العظم في مجموعة المرضى.النتائج: كان عمر مجموعة المرضى يتراوح بين 44-82 سنة بمعدل 61,8 ±6,14 سنة. وكان معدل الذكور الى الاناث هو 1,8 :1 وكان 57,5% منهم ليس لديه أية أعراض مرضيم مهمة. لم يتم إكتشاف الانترلوكين-6 في دم مجموعة السيطرة بنسبة أكبر من مجموعة المرضى (39,6% , 13,2% على التوالي). بينما كانت مستويات الانترلوكين-6 أعلى في دم مجموعة المرضى (12,6±5,1 بيكوغرام/مللتر) مقابل 6,2 ±2,3 بيكوغرام/مللتر لدى مجموعة السيطرة (قيمة P<0.05).الاستنتاج: ان إرتفاع نسبة الانترلوكين-6 لدى مرضى إبيضاض الدم اللمفاوي المزمن يدل على العلاقة المهمة بينهما. تبقى الحاجة ملحة إلى المزيد من الدراسات لاضاءة الجوانب المظلمة من هذه العلاقة المركبة.


Article
Pure red cell aplasia in chronic lymphocytic leukemia: Case report and review of literature

Authors: Liqaa M. Al‑Shareefy --- Hassanain H. Al‑Charrakh
Journal: Iraq Joural of Hematology المجلة العراقية لامراض الدم ISSN: 20728069/25432702 Year: 2016 Volume: 5 Issue: 2 Pages: 187-191
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Despite being immune deficient, chronic lymphocytic leukemia (CLL) patients have an increased incidence ofautoimmune cytopenias secondary to autoantibody formation. These are: warm autoimmune hemolytic anemia;idiopathic thrombocytopenia; pure red cell aplasia (PRCA), and In this case report, we describe a patient withCLL who developed severe anemia requiring frequent red cell transfusion after the third cycle of chemotherapy.Blood film showed no evidence of hemolysis and absolute reticulocytopenia. Bone marrow showed erythroidhypoplasia and residual interstitial infiltrate of CLL. The diagnosis of CLL‑induced PRCA was made, and thepatient showed a prompt and dramatic response to treatment with cyclosporine.

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