CLINICAL IMPLICATION OF REAL-TIME QUANTITATIVE PCR ANALYSIS OF HUMAN TELOMERASE GENE EXPRESSION & FLOW-CYTOMETRY DETECTION OF ZETA ASSOCIATED PROTEIN IN B-CHRONIC LYMPHOCYTIC LEUKEMIA
Agha AM*, Sadek H**, EL Shakankiri AA**, Abdel Rahman A*, Rachwan MMT*
Department of Clinical and Chemical Pathology Faculty of Medicine, Benha University* & Cairo University**
B cell chronic lymphocytic leukemia (BCLL) is a malignant lymphoproliferative disorder of mature B lymphocytes. BCLL is characterized by extremely heterogeneous clinical course. Advances in the biology of B-CLL worked for the identification of newly prognostic markers that might facilitate risk adapted treatment strategies. This study aims to assess expression of telomerase gene and Zeta associated protein kinase-70 in B-CLL patients, as well as to correlate these parameters with each other and with the traditional staging system in order to find their significance as prognostic markers. The current study was conducted on 30 patients attended to NEMROCK (Kasr El Aini center of Radiation, oncology and hematology department) Cairo University from December 2006 to December 2007. Patients were newly diagnosed BCLL, no treatment was started before samples collection. Patients were stratified according to Binet stage whatever is the age and sex. Patients’ age ranged from 47-72 years with mean 59.1+7.3 year. 16 (53%) were males and 14 (47%) were females; with ration 1.1:1. Lymphadenopathy and splenomegaly represented the most frequent clinical presentations (76.7% & 66.7% respectively). 30% of cases were positive for ZAP-70 & 70% were negative. There was statistical significant positive correlation of Binet stage with total leucocyte count and absolute lymphocyte count. The mean SD of hTERT expression unit is higher in positive ZAP-70 cases, but with no significant correlation. There was a positive correlation between ZAP-70 expression and Binet stages. It means that high positivity of ZAP-70 expression is shown to predict bad prognostic course of B-CLL patients. As regard hTERT, high mean SD was found in patients with positive ZAP-70 expression. But this data still needs further studies to confirm its value as a prognostic marker. Putting into consideration it is expensive and sophisticated techniques.