Expression of vascular endothelial growth factor and its receptors FLT-1 and KDR in acute leukemia: Clinical relevance and future prospects

Vascular endothelial growth factor [VEGF] and its receptors may play an important role in the pathophysiology of hematopoietic malignancies and the progression of leukemia. The present work aimed to study the expression of VEGF and its receptors namely FLT-1 [VEGFR-1] and KDR/FLK-1 [VEGFR-2] on the transcriptional level in fresh leukemic blast cells isolated from newly diagnosed AML and ALL patients by RT-PCR. The present study demonstrated that acute leukemia whether myeloblastic or lymphoblastic express VEGF and to less extent express its receptors namely FLT-1 and KDR. This may result in the generation of autocrine loop that may support leukemic cell survival and proliferation. On the contrary, to the lack of expression in normal bone marrow samples, VEGF, FLT-1 and KDR were expressed in considerable percentage of the studied AML and ALL patients. There was no significant relationship between the expression of VEGF or its receptors and patients' clinical or laboratory findings. Expression of VEGF and/or KDR receptors was associated with unfavorable treatment outcome and they were associated with risk of treatment failure. This data show that VEGF, FLT-1 and KDR may have clinical relevance and raise the possibility of using angiogenesis inhibitors as a novel therapeutic strategy in acute leukemia. By developing treatment strategies that target both the stromal and tumor compartments, drug resistance may be overcome, and the effect on therapeutic outcome enhanced

Evaluation of qualitative and quantitative platelet defects using flow cytometry

The diagnosis of platelet defects and inappropriate platelet activation is associated with some difficulties. Flowcytometry has been reported to be ideally suited for studying several clinical aspects of platelet pathophysiology and platelet function. In this study, the methodology and clinical utility of reticulated platelet analysis, platelet associated immunoglobulin and platelet expression of P-selectin [CD62] and glycoprotein IIbIIIa [CD41] in some platelet disorders were explored. The study included a total of 72 cases classified into 35 cases of ITP, ten cases of ITP in remission, seven cases of Glanzmanns thrombasthenia, six cases with aplastic anemia and 14 age matched controls. Data showed that flowcytometric analysis can be used as a reliable measure of important diagnostic aspects of qualitative and quantitative platelet disorders and it can be used to assess circulating activated platelets