تأثير التعبير عن المستضدات النقوية على معدلات البقيا عند الأطفال المصابين بابيضاض الدم اللمفاوي الحاد

الملخص EN

Objective : The role of myeloid antigens in acute lymphoblastic leukemia patients is still controversy.

Some researches reveals a negative role on both diagnosis and survival rate so it is considered a risk factor, while others show no role of it on survival rate in all patients.

The aim of present work was to evaluate the role of myeloid antigens on survival rate in children with acute lymphoblastic leukemia (ALL) in University Children Hospital in Damascus.

Methods : Retrospective study of 130 patients with acute lymphoblastic leukemia were admitted in children hospital from 2008 to 2009.

By flow cytometry, we detect the myeloblastic surface antigens on blast cell, using the immune fluorescent antibodies.

So, we considered the result positive if the cells have more than 20% of surface antigen.

The number of patient patients was 130 diagnosed with lymphatic leukemia between 2008 and 2009.

The clinical examination showed the presence of hepato-splenmegaly with nodular, and hemorrhagic signs in most cases.

A peripheral smear was performed for all patients, in addition, to bone marrow aspiration.

Patients were divided into two morphological groups: L1-L2 based on FAB recommendations.

In treatment and follow up period, patients were divided into two risk groups: Standard risk and high risk.

Patients received chemotherapy according to the modified BFM-95 protocol according to our country, taking into account the classification of patients in the two risk groups, where NR-protocol and HR-ALL protocol were applied.

Patients received an intensive treatment plan of 6-9 months included Induction-Consolidation-Interval therapy- reinduction reconsolidation, then a maintenance therapy for two years.

Patients were followed periodically with clinical and laboratory surveillance bone marrow aspiration, and cerebral spinal fluid drainage periodically during the treatment period to determine the response to the treatment and the remission.

Follow-up was carried out for five years from the start of the first remission to determine the survive rate.

Results: Twenty eight of 130 patients with ALL have a positive CD13 and/or CD33, this about 22%.

The patients were subclassified into two groups: First group: patients acute lymphoblastic leukemia without myeloid antigen (ALL MY-), Second group: patients acute lymphoblastic leukemia with myeloid antigen (ALL MY +).

In the first group, the survival rate in 36 months and 60 months from the diagnosis, was 56% and 45% respectively.

However, in the second group the survival rate in 36 months and 60 months from the diagnosis was 54% and 46% respectively.

That means no significant statistically difference between these two groups in the survival rate, also no different in clinical signs and symptoms or laboratory results in these two groups except for low platelets counts in the group 1 (ALL MY -) compared with second (ALL MY +).