RESUMO
Chronic lymphocytic leukemia (CLL) is the most common chronic lympho‑proliferative disorder. This study done to detect the level of cluster of differentiation (CD)49d in CLL patients by flow cytometry and itscorrelation with the prognosis (survival) and with (trisomy12) detected by fluorescent in situ hybridization (FISH).Methods:Clinico-hematological profiles done to fourty CLL patients. CD49d tested by flow cytometry and trisomy12 was detected by FISH.Results:CLL patients classified according to modified Rai staging system into: low risk 12.5%, intermediate risk 22.5% and high risk 65%. CD49d and trisomy12 positivitywere detected in 29Original Research Article patients (72.5%) and 22 patients (55%), respectively. There was a significant positive correlation between the percentage of trisomy12 and of CD49d cells in CLL patients (P =0.034). And also, between CD49d and CD38 (P =0.034). On the other hand, there was no significant relation between both CD49d and trisomy12 expression and modified Rai staging system.As regard to overall survival (O.S) and disease free survival (DFS), both CD49d, trisomy12 positive cases were associated with shorter disease free, and overall survivals compared to the negative cases.Regarding to the relation between the use of combination of fludarabine, cyclophosphamide, and rituximab (FCR) as a standard treatment in CLL and OS and DFS of patients in our study, we found that FCR account for the better outcome associated with its use.Conclusion:CLL B-cell membrane expression of CD49d as measured by flow cytometry is a powerful prognostic parameter in patients with CLL. Its positive correlation with the trisomy12 and CD38 and the association of both CD49d and trisomy12 with short survival times indicate that they may have roles in the prognosis of CLL
RESUMO
To examine the validity of US in assessing hand osteoarthritis [OA] and to study the relationship between ultrasonographic findings and OA symptoms. This study was carried out on thirty patients with primary hand OA, and fifteen healthy subjects serving as a control group. Patients were classified according to ultrasonographic findings of joint involvement into two subgroups: 15 patients with interphalangeal [IP] OA and 15 patients with IP and first carpometacarpal [CMC] joint OA. All hand joints were examined for tenderness, soft tissue swelling, hard tissue enlargement [nodes], and deformity. Functional assessment by AUSCAN questionnaire, grip and pinch strength measurement and pain assessment by Visual Analogue Scale [VAS] were carried out. Plain X-rays of both hands were taken and classified according to the Kellgren-Lawrence [K-L] grading scale. High resolution US of the hand joints was performed which focused on examining cartilage thinning, joint space narrowing [JSN], and osteophytes [OST]. There was a positive correlation between the K-L grading and US findings regarding JSN and OST. There was a positive correlation of AUSCAN score with cartilage thinning, OST and JSN. There was a negative correlation of grip strength with cartilage thinning and OST. There was a negative correlation between pinch strength and US findings [cartilage thinning, OST and JSN]. There was a positive correlation between pain and US findings. Heberden's nodes were associated with underlying distal IP cartilage thinning, OST and JSN. On comparing the two subgroups of patients; patients with both IP and first CMC joint involvement experienced significantly higher levels of pain and disability and had weaker pinch strength. Ultrasonographic findings correlated with clinical findings as nodes, functional parameters as grip and pinch strength, and pain. The increased detection of OA structural pathology by US may make this a useful tool for hand OA assessment