1Pathology Department, College of Medicine, Mustansiriyah University, Baghdad, Iraq
2Pathology Department, College of Medicine, Mustansiriyah University, Baghdad, Iraq
Online published on 8 March, 2019.
Chronic lymphocytic leukemia (CLL) is the most frequent leukemia of adults in the Western world. Proliferation of lymphocytes in bone marrow, blood and lymphoid tissues causes heterogeneous clinical course. So, many efforts focus on finding reliable indicators that can help predict the outcome, or explain the clinical variability, of CLL. Expression of surface proteins such as CD38, CD49d and ZAP-70 on leukemic cells have been proven as a dependable prognosticator of poor outcome, other novel markers such as CD26 has been emerged, but it needs thorough assessment for their prognostic capacity in CLL. Current study was aimed to assess the Immunohistochemical expressions of CD26 in bone marrow biopsies of CLL patients and correlate it with clinico-pathological parameters.
Cross-sectional study was done on forty bone marrow paraffin blocks of untreated patients with CLL. Immunohistochemical staining for CD26 and CD38 antibodies were studied in relation to clinico-pathological details.
Expression of CD26 was seen in 60% of specimens which showed a moderate intensity in 91.6% and score (2) in 50% of cases. A significant association between CD26 and each of Binet stage C, Rai stage IV, Hemoglobin <10g/dl, and platelets count <100*109/l) was reported.
Immunohistochemistry can be used reliably to assess the expression of CD26 in CLL cases. It was significantly correlated with more advanced stage and poor prognostic signs. It is found that CD26 is more sensitive, specific and accurate than CD38 in prediction of high risk CLL patients (Binet stage C). We recommend further prospective studies related to therapeutic responses and assessment of CD26 expression in relation with other prognostic indicators.
Chronic lymphocytic leukemia, CD26, CD38, immunohistochemistry, Binet staging, Rai staging
