الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Chronic lymphocytic leukaemia is the most common adult leukaemia in the world.
The classic features of CLL include a clonal CD5 positive B lymphocyte population with a peripheral count of a minimum of 5000 cells/m3L, bone marrow lymphocytosis and varying degrees of cytopenias and hepatosplenomegaly.
CLL is a clinically heterogeneous disease with an extremely variable clinical course and disease outcome.
Nowadays there is growing recognition of the association of MRD status in CLL as a predictor of both progression free survival and overall survival.
The aim of the present work was the use of four-color flow cytometry using CD5/CD19/CD20/CD79b in a way to increase the specificity of detecting neoplastic B cells considered as minimal residual disease for B-CLL.
Thirty-one CLL patients were enrolled in the study. Twenty age and sex matched healthy individuals were included as a control group to determine the expression of the different cluster of differentiation antigens mentioned in the study on normal B-cells.
All patients in the study were subjected to full history taking, complete clinical examination. The patients were diagnosed by flow cytometric immunophenotyping according to CLL scoring system.
In the present study, twenty-seven cases with typical morphology were identified, while four cases with atypical morphology were recorded; one with score 3/5. They were considered CLL with atypical morphology. The expression of CD79b was observed to vary from typical as compared to atypical CLL patients; with significantly higher MFI percentage in the atypical cases.
In the normal bone marrow samples included in the study; a comparison between CD5+B cells and CD5-B cells as regards % and MFI was studied. The percentage of B cells in general (CD5+ and CD5-) is detected to be low in count. CD20+/CD5+ is a significantly smaller population than CD20+/CD5- with a significantly higher MFI of CD20 in the CD5+ population. However the MFI of CD79b did not vary between the CD5+ and CD5- B cells.
In addition CD5+ B cells (normal counterpart of CLL) were studied and recorded in peripheral blood and bone marrow, this was done to prove that we were able differentiate between the CLL population and its normal counterpart and that the results of MRD detection was feasible.
In our study in hand, typical and atypical subgroups were compared to each other, which yielded that the most striking difference between them is the CD79b expression, which was significantly lower in typical cases than atypical cases.
Also our CLL patients enrolled in the study were compared to the control group, which recorded that CD5/CD19, CD20 and CD79b percentages showed significantly higher values than the control groups, while CD20 and CD79b MFI values recorded a significantly lower values than the control groups.