Smudge cell percentage as a surrogate marker for ZAP-70 expression in patients with chronic lymphocytic leukemia

BACKGROUND: This study aimed to evaluate the prognostic value of smudge cell percentage as a surrogate marker for zeta-chain-associated protein kinase 70 (ZAP-70) expression in chronic lymphocytic leukemia (CLL) patients. METHODS: Sixty three newly diagnosed CLL patients were investigated at the Hematology Department of the Medical Research Institute of Alexandria University with complete blood count, lactate dehydrogenase, β2 microglobulin levels, ZAP-70 expression, and estimation of the percentage of smudge cells. RESULTS: The percentage of smudge cells ranged from 2 to 58% with a mean of 24.03±13.98%. Higher percentages of smudge cells (>30%) were statistically significantly associated with markers of better prognosis (negative ZAP-70, early-stage disease according to the Binet and Rai staging systems, as well as low and intermediate risk CLL prognostic index). The percentage of smudge cells showed significantly negative correlation with the ZAP-70 expression and higher area under the curve for prediction of ZAP-70 positivity with better survival for 36 months in patients with >30% smudge cells. CONCLUSION: The percentage of smudge cells at presentation of newly diagnosed CLL patients could be used as a surrogate marker for ZAP-70 expression and an additional prognostic marker for disease progression.

Study of urinary N-Acetyl-Glucosaminidase enzyme and urinary zinc excretion in children with beta-thalassemia major

Thalassemia is a common genetic disease. Patients usually have some forms of renal tubular dysfunction, which might be expressed by an increase in urinary excretion of marker enzymes such as N- Acetyl-beta-D-Glucosaminidase [NAG]. Also, zinc deficiency may be associated with thalassemia to varying degrees. Zinc is an essential trace element necessary for growth and for regulation of normal physiological functions. The aim of the present work was to study urinary NAG, serum zinc, RBC's zinc and urinary zinc excretion in children with beta-thalassemia major, Also, to study the effect of Desferrioxamine [DFO] therapy on these parameters. The study was conducted on 40 beta-thalassemic children divided equally into two groups. Group [A] included 20 children with a mean age 8 + 3.48 years who received regular iron chelation with DFO and group [6] included 20 children with a mean age 7.1 2 4.36 years who did not receive DFO. Twenty normal healthy children matched by age and sex were included as controls [group C]. Number of blood transfusions received by each child has been approximately calculated. The mean value in-group A was 115.55 +/- 89.96, and in-group 6, it was 70.8 +/- 189.29. There was no statistically significant difference between the two groups [P=0.123]. The mean RBCs zinc in the present study was higher in patients groups [AandB] than in-group C with a statistically significant difference, while serum zinc levels were not significantly different among the three groups. Also, the mean urinary zinc excretion level was statistically significantly higher in-group A than in-group B and both groups had statistically higher significant values than the control group. Finally, the NAG levels showed a statistically significant difference between the patients groups [AandB] and the control group. The mean value was 3.23 +/- 1.98 U/L in group A and 3.02 +/- 1.59 U/L in-group 6, while it was 1.84 +/- 0.76 in the control group

Conclusion: thalassemic patients seem to be protected from zinc deficiency but there may be an impairment of zinc utilization at tissue level. Also, urinary NAG excretion can be considered as a reliable marker of tubular damage and its determination is recommended for early detection of renal problems

Effect of acute inflammatory response to maximal and submaximal exercise on iron-related indices

Twenty male subjects were studied to evaluate the effect of inflammatory response on iron status after maximal and submaximal exercises aiming to identify the appropriate intensity with minimal effect on iron status. The resting levels of the iron related indices were within normal range, whereas, after submaximal and maximal exercises, a fall in serum iron [-28.23%+15.31, - 27.4%+10.14], percent transferrin saturation [-25.71% +/- 12.5, - 33.77% +/- 13.65] and serum ferritin [-2.46% +/- 6.32, - 3.66% +/- 5.63] and a rise in the white cell count [59.5% +/- 13.31, 74.59%+10.12] with release of lactoferrin [73.47% +/- 27.28, 88.6+27.94] were noted. These changes were attributed to the known actions of interleukin-1 [IL-1] being one of the mediators of acute inflammatory reaction as evidenced by the positive correlations found between interleukin-1 and lactoferrin levels both after submaximal and maximal exercises. Moreover, positive correlation was observed between minute oxygen consumption [VO[2]] and [IL-1] level after both types of exercises denoting that the more the subject is fit the more he withstands the tissue hypoxia. The percent changes in serum lactoferrin, white blood cells and interleukin-1 due to maximum exercise were significantly higher when compared with the corresponding values after submaximal exercise. We conclude that although both maximal and submaximal exercises stimulate the acute phase response, yet the submaximal exercise exerts a less harmful effect on iron indices