International Journal of Science and Research (IJSR) ISSN (Online): 2319-7064 Index Copernicus Value (2013): 6.14 | Impact Factor (2014): 5.611 Volume 5 Issue 1, January 2016 www.ijsr.net Licensed Under Creative Commons Attribution CC BY CD56 and CD19 Antigens Expression in Acute Myeloid Leukemia Identifies Patients with Adverse Prognosis in Egypt Running head: CD56 and CD19 antigens and Acute Myeloid Leukemia prognosis Shereen El Shorbagy M.D. 1 , Rasha Haggag, M.D. 2 , Nashwa Alazizi, M.D. 3 , Tarek Abouzeid, M.D 4 1, 2 Department of Medical Oncology , Faculty of Medicine, Zagazig University, Sharkia, Egypt 3 Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Sharkia, Egypt 4 Department of Internal Medicine, Hematology unit, Mansoura University, Egypt Abstract: CD56 was firstly described as a marker of natural killer cells and has been found expressed in several neoplasms including acute myeloid leukemias (AML), the presence of CD56 antigen on blast cells may influence complete remission and survival. CD19 is a B-lymphocyte marker, whose expression is associated with pediatric AML-M2 and the t(8;21) translocation. The biological and clinical significance of CD19 expression in AML is not clear. Patients and Methods: fifty de-novo AML were included, bone marrow aspirate subjected to immunophenotyping for lymphoid marker CD 19 and CD56, and cytogenetic study (karyotyping and FISH) and results were correlated with clinical outcome. Results : Fifty patients were included of which, 22 were male and 28 were female, with a median age of 40 years (16-75). There is a significant correlation between CD56 expression and cytogenetic abnormalities associated with unfavorable prognosis (P = 0.001), while the correlation between CD19 expression and cytogenetic analysis was not significant (p=0.06). CD56& CD19 expression did not influence CR rate (P = 0.51, p=0.08; respectively). Expression of CD56& CD19 had adverse effect on DFS (p=0.03 and p<0.00; respectively), and on OS (p=0.001 and p=0.001; respectively). Conclusion : CD56 and CD19 expression may identify acute myeloid leukemia patients with adverse prognosis. Keywords: Acute Myeloid Leukemia; Immunophenotyping; CD56; CD19, prognosis. 1. Introduction Acute myeloid leukemia (AML) could be considered as a heterogeneous group of disorders which often present with different morphological, immunophenotypic and cytogenetic patterns (1–3). Identification of these characteristics may be useful for a better prognostic evaluation and for a more appropriate therapeutic approach. Occurrence of aberrant phenotype has been reported in acute leukemias with varying frequency though its prognostic importance remains controversial (1). CD56 antigen, a 200–220 kDa cell surface glycoprotein, identified as an isoform of the neural adhesion molecules (NCAM)(4-6), it was firstly described as a marker of natural killer cells and subsequently, has also been found expressed in several lympho–hematopoietic neoplasms including acute myeloid leukemia (AML)(7-10). In fact, it has been previously reported that in AML patients with t(8;21) (q22;q22), generally considered at lower risk of relapse, the presence of CD56 antigen on blast cells may influence complete remission (CR) duration and survival (11), suggesting that CD56 expression could be useful in stratifying therapeutic approaches for this subtype of AML.(11,12). CD19 is a phosphoglycoprotein lymphoid antigen which expressed normally on follicular dendritic cells& B cells; it is commonly expressed in AML-M2 (13). In order to better clarify the prognostic role of CD56& CD19 expression in AML cells, we evaluated the presence of these antigens on leukemic cells of fifty newly diagnosed AML patients and results were correlated with the clinical outcome. 2. Patients & Method Fifty newly diagnosed adult AML cases presenting to Medical oncology, clinical pathology departments, Zagazig University, and Hematology unite, Internal medicine department, Mansoura University, Egypt,( between may, 2013 and may, 2014) were included in this study. Before starting chemotherapy, adequate immunophenotype studies and, in the majority of patients, cytogenetic analyses were performed. Complete blood count (CBC) was done using automated cell counter; Sysmex SF 3000(Roche-Diagnostics,Manheim, Germany). Bone marrow aspirates were examined for the presence of blast cells and the diagnosis of each leukemias subtype was established according to morphological, cytochemical and immunological criteria according to the French-American-British (FAB) and World Health Organization (WHO) classifications. 3. Conventional karyotyping Culture: The BM cells(on heparin) were cultured in a medium {RPMI 1640 supplemented with fetal calf serum (Gibco ,USA), L-glutamine (Gibco BRL) penicillin and Paper ID: NOV152554 523