الفهرس 
acknowledgementOnly 14 pages are availabe for public view
 |  | from | 133 |  |  |
| | | from | 133 | | |
Abstract
This study was performed on 60 patients with lymphoid discords (37 male and 23 female). Patients were subdivided into three groups: patients with benign lymphocytosis, patients with acute lymphoid disorders, and patients with chronic lymphoid disorders. The following investigations were done: 1. Full clinical evaluation including: Entire history taking including: (age, sex, therapeutic history, blood transfusion). Clinical examination including: (anemic manifestation, fever, hepatomegaly, splenomegaly, lymphadenopathy, bleeding tendency, and bone tenderness). 2. Blood samples: Two ml of venous blood was withdrawn into ethylene diamine tetraacetic acid (EDTA) used immediately for complete blood counting with spreading of peripheral blood smears for Leishman staining and differential leucocytic counting. BMA sample was collected in EDTA tube for each patient from the anterior or posterior superior iliac spine, half ml of BM aspirate was mixed immediately on glass slides, and smears were spread to be examined after staining by Leishman stain. One ml of BM aspirate was gently dispensed into a K-EDTA solution tube for FCM immunophenotypic analysis. The sample used for FCM was evaluated within 24 hours and stored at room temperature. 3. Laboratory Investigations: a- CBC was done using ADVIA 2120i, including hemoglobin (Hb) level, RBCs indices, total leukocytic count, differential leukocytic count, platelet count, platelet indices, and, Reticulocytes. b- Examination of peripheral blood films stained with Leishman stain for differential leukocytic count and detection of Blast cells. c- Examination of Leishman stained BM aspiration smears for assessment of BM cellularity, morphological BM proliferation, and cytochemical examination by Sudan black B, Nonspecific esterase, and Periodic acid Schiff. d- Immunophenotyping was done by Becton-Dickinson fluorescence-activated cell sorter (BD FACSCalibur) using MoAbs (BD and Immunostep). Immature cell type of malignant lymphoid disorders had high significant expression of CD71 in compared to benign and mature cell type of malignant lymphoid disorders. CD71 expression increase in cases which , had high expression of immaturity markers ( cyto TdT and CD34 ). In Pre-B-ALL, all cases had high expression of CD71show high expression of cytoTdT and CD34 markers of the immaturity of cells. In common B-ALL, 50% of patients had high expression of CD71and high expression of cytoTdT and CD34 with a positive correlation. Cases of lymphoma NHL show positive expression of CD71, the highest expression in T- NHL, and cases of multiple myeloma had high expression of CD71, CD71 expression was significantly higher in T-ALL than B-ALL in the present study. In T-ALL, the expression of CD71 reached 85% was the highest expression in all cases. In our study, common B-ALL and pre-B-ALL patients show the CD71 positivity of 50% and 100%, respectively. In addition, the CD71 expression was highest seen in T-ALL followed by pre-B-ALL and lymphoma, and the lowest expression in benign lymphocytosis, common B-ALL, and CLL was seen in the present study. In conclusion, CD71 help in the differentiation of lymphoid disorders and further help in discriminating the differentiation status of ALL. High CD71expression might reflect a much aggressive and immature cell type. However, further prospective studies are needed to document the possible relation of CD71 with response to treatment and relapse rate. Also, studies relate CD71 with clonal evolution in leukemia may predict the possibility to be an important molecular target in future therapy of acute leukemia.