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Study of soluble CD44 and its expression by mononuclear cells in children with acute lymphoblastic leukemia: its
Mohammed Ibrahim Sayed Ahmed1, Hoda Mohammed Abo El Fotoh Hassab
1Department of Clinical Pathology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt.
Insights
Soluble CD44 (sCD44) and CD44 expression are elevated in pediatric acute lymphoblastic leukemia (ALL) and decrease with remission. High sCD44 at diagnosis indicates a potential marker for prognosis and therapy response in ALL patients.
Area of Science:
- Pediatric Oncology
- Immunology
- Biochemistry
Background:
- Acute lymphoblastic leukemia (ALL) is a significant pediatric cancer.
- CD44 is a cell surface glycoprotein involved in cell adhesion and migration.
- Soluble CD44 (sCD44) levels and CD44 expression in ALL require further investigation for prognostic value.
Purpose of the Study:
- To measure sCD44 and CD44 expression in pediatric ALL patients.
- To assess changes in sCD44 and CD44 expression before and after induction of remission.
- To correlate sCD44 and CD44 expression with prognostic factors in pediatric ALL.
Main Methods:
- Quantification of sCD44 using ELISA in 30 newly diagnosed pediatric ALL patients and controls.
- Assessment of CD44 expression via flow cytometry in the same patient cohort.
- Correlation analysis with clinical parameters including age, sex, TLC, Hb, platelet count, blast percentage, immunophenotyping, and LDH.
Main Results:
- CD44 expression was significantly higher in ALL patients (41.23%) compared to controls (5.5%) and decreased after remission (P=0.001).
- sCD44 concentration was significantly higher in ALL patients (246.5 ng/dl) than controls (160.65 ng/dl) and decreased after remission (P=0.001).
- Elevated LDH levels correlated with anemia, high TLC, and high blast counts, indicating a risk determinant.
Conclusions:
- High sCD44 levels at diagnosis and their decline post-treatment suggest sCD44 as a potential marker for ALL prognosis and therapy response.
- A secondary rise in sCD44 may indicate relapse in ALL patients.
- Elevated CD44 expression might contribute to lymphoblast metastasis in ALL.
Abstract:
To measure sCD44 and its expression in ALL children before and after induction of remission (day 28) and their relation to prognostic factors. Newly diagnosed 30 ALL pediatric patients were examined for sCD44 by ELISA and CD44 expression by flowcytometry and their levels after induction of remission. We correlated them to age, sex, TLC, Hb, platelet count, blast % in PB and BM, Immunophenotyping, and LDH. CD44 expression in ALL patients at the time of diagnosis ranged from 0 - 98% with a mean +/- SD of (41.23 +/- 23.99) and in the control group (range 0 - 11 with a mean +/- SD of 5.5 +/- 6.58), the % of expression was significantly higher in ALL patients than control group (P = 0.001). CD44 expression was significantly decreased by induction of remission (P = 0.001). sCD44 concentration in ALL patients at the time of diagnosis ranged from 105- 449 ng/dl with a mean +/- SD of (246.5 +/- 99.51) and in the control group (range 103 -243 ng/dl with a mean +/- SD of 160.65 +/- 37.12), sCD44 was significantly higher in ALL patients than control group (P = 0.001). sCD44 was significantly decreased after induction of remission (P = 0.001). LDH was elevated in the patients group than the control, (P = 0.001). In conclusion, LDH level at time of ALL diagnosis is an important risk determinant and correlate with degree of anemia, high TLC and high PB absolute blast count. High sCD44 level at the time of diagnosis and rapid decline in its level after treatment suggesting that sCD44 may be a good marker for prognosis and a marker for monitoring response to therapy, a second elevation of sCD44 level after its decline by therapy may suggest ALL relapse. Elevated CD44 expression in ALL patients may mediate lymphoblast metastatic migration.
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