الفهرس 
B-Chronic Lymphocytic LeukemiaOnly 14 pages are availabe for public view
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Abstract
Chronic Lymphocytic Leukemia (CLL) is a heterogeneous disease consisting of monoclonal small B-cell lymphocytes, caused by both increased proliferation and accumulation of small mature appearing CD5+ B- lymphocytes in blood, bone marrow and lymphoid tissues.
The pathogenesis of B-CLL remains largely unknown, it may be due to defective apoptosis, genetic aberrations or cytokines. Numerous studies aimed at determining reliable prognostic markers capable of predicting the progression and outcome of the disease, such as molecular markers, chromosomal analysis by conventional cytogenics and interphase fluorescence in situ hybridization, CD38 expression, and examination of bone marrow infiltration pattern.
Hypoxia-inducible factor-1alpha (HIF-1alpha) is an oxygen-dependent transcriptional activator, which plays crucial roles in the angiogenesis of tumors and mammalian development. The stability and activity of HIF-1alpha are regulated by various post-translational modifications, hydroxylation, acetylation, and phosphorylation.
The present work aimed to measure the level of HIF-1 alpha in CLL patients using flowcytometry and to correlate it with the staging system, LDH and CD 38.
Peripheral blood samples were obtained from 40 B-CLL patients; 28 males and 12 females with male to female ratio of 2.3:1.
All patients were subjected to analysis of HIF-1 alpha expression. HIF- 1α was positively expressed in 28 of the cases (above the cut off = 30.78). The percentage expression of HIF- 1α was significantly higher among patients in late stages of Rai staging.
HIF- 1α was related to Rai staging, LDH & CD38. But it was not related to the absolute lymphocyte count or the degree of bone marrow infiltration.
The prognosis of patients with low HIF- 1α on diagnosis is better than patients with high HIF-1α level.
HIF-1α can be used as a marker to detect response of treatment and disease outcome indicating its importance as an independent prognostic factor and its promising target for therapeutic intervention.
from this study we concluded:
- HIF- 1α is highly expressed in CLL patients with late stages of Rai staging.
- HIF- 1α is significantly related to CD38, LDH and disease outcome.
- In CLL patients, HIF- 1α had prognostic impact and it could be used as an independent prognostic marker.