Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Clinical and Chemical Pathology

Introduction: A great number of distinct antigens affect AML prognosis and prediction. Nevertheless, difficulties are still found in performing accurate risk stratification for diagnoses based on immunophenotypic features. Improving the accuracy of prognostic assessment of AML may allow the treatment to be more specific and risk-adapted. Here, we measured CXCR4, VLA-4 and CD200 expressions in leukemic myeloblasts to determine their prognostic implications. Methods: Using multicolor flow cytometry, our studied markers expressions were measured in leukemic myeloblasts in bone marrow aspirates that were obtained from newly diagnosed adult AML patients (n=80). Median values of the studied markers expression divided patients into high and low expressing groups. Results: High VLA-4 expression was associated with gum hyperplasia (p=0.028). FAB (M4, M5) was significantly higher within the high CXCR4 expressing group and nearly significant within the high VLA-4 expressing group (p=0.04 and 0.07 respectively). Among the 75 non-promyelocytic leukemia patients analyzed who received cytarabine + anthracycline-based induction chemotherapy, high VLA-4 expression was associated with longer disease free survival (p=0.005) and progression free survival (p=0.009) and a trend of longer overall survival. High CD200 was associated with longer overall survival (p=0.042) and progression free survival (p=0.044)

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