Demographic and prognostic factors of 455 patients with acute leukemia admitted to two referral hospitals in Tehran-Iran during ten years [2001-2011]

Global death toll of Acute Leukemia [AL], as a heterogeneous group of hematopoietic malignancies, is rather high, i.e. almost 74% of 300,000 new cases die every year. This reflects a poor prognosis of this malignancy in most parts of the world, where contemporary and rather complex remedies are not available. There are a few well documented reports about the epidemiologic features of AL at national level in Iran. This retrospective study demonstrates demographic and laboratory features of Acute Myeloid Leukemia [AML] and Acute Lymphoblastic Leukemia [ALL] patients admitted to the main referral oncology hospitals in the ex-Iran University of Medical Sciences in Tehran [Firoozgar and Rasoul-Akram hospitals] during the last decade [2001-2011]. Medical records of all patients admitted to the both hospitals diagnosed with AML and ALL were reviewed during the study period for demographic, biological and clinical characteristics at diagnosis. Four-hundred fifty five patients were diagnosed with AML and ALL, who admitted to the both hospitals during ten years, of whom 59.6% [271 patients] were male. Fifty five percent of patients had AML and 44.6% had ALL, both significantly dominated in men [p<0.001]. AML patients died more significantly [p<0.05] and the most deaths occurred in older patients [p<0.001]. Initial WBC count was significantly related to death [p= 0.001], where the least death [13%] occurred in the group with initial WBC between 5-10x103/microL and most of deceased had an initial WBC more than 10x103/microL. Logistic regression showed that age, fever and WBC were significant prognostic factors. Demographic characteristics of AL patients were almost the same as other global reports. Most deaths occurred in older patients, those who had fever, and patients with higher WBC count at first admission, which warrants more investigations accurately and also improvements in hospital records

Comparative expression profile of orphan receptor tyrosine kinase ROR1 in Iranian patients with lymphoid and myeloid leukemias

It has recently been shown that ROR1, a member of the receptor tyrosine kinase family, is overexpressed in leukemic B cells of Chronic Lymphocytic Leukemia [CLL] and a subset of Acute Lymphoblastic Leukemia [ALL]. In this comparative study the expression profile of ROR1 mRNA was investigated in Iranian patients with CLL and Acute Myelogenous Leukemia [AML] and the results were compared with those previously reported in our Iranian ALL patients. RT-PCR was performed on bone marrow and/or peripheral blood samples of 84 CLL and 12 AML patients. CLL samples were classified into immunoglobulin heavy chain variable region [IGHV] gene mutated [n=55] and unmutated [n=29] and also indolent [n=42] and progressive [n=39] subtypes. ROR1 expression was identified in 94% of our CLL patients, but none of the AML patients expressed ROR1. No significant differences were observed between different CLL subtypes for ROR1 expression. Taken together the present data and our previous results on ROR1 expression in ALL, our findings propose ROR1 as a tumor-associated antigen overexpressed in a large proportion of lymphoid [CLL and ALL], but not myeloid [AML] leukemias. Expression of ROR1 seems to be associated to lineage and differentiation stages of leukemic cells with a potential implication for immunotherapy

Immunophenotypic characterization of the leukemic B-cells from Iranian patients with chronic lymphocytic leukemia: association between CD38 expression and disease progression

Patients with B-cell chronic lymphocytic leukemia [B-CLL] have heterogeneous clinical courses, thus several biological parameters need to be added to the current clinical staging systems to predict disease outcome. Recent immunophenotypic studies performed mainly in Western populations have demonstrated the prognostic value of CD38 and ZAP-70 expression in B-CLL. To investigate the expression pattern of a variety of membrane antigens on leukemic cells from Iranian patients with CLL and to find out if there are any differences in the expression of these markers between indolent and progressive groups. In the present study, peripheral blood samples from 87 Iranian patients with B-CLL were analysed by flow cytometry. In all cases, the neoplastic cells displayed B-CLL phenotype [CD5[+]/CD19[+]/sIg[+]]. The vast majority of the cases expressed CD23, but failed to stain for CD3 or CD14. The leukemic cells of most patients expressed CD27 [84/87, 95.4%] and CD45RO [74/87, 83.9%] molecules, suggesting a memory B-cell phenotype. Comparison between the indolent [n=42] and progressive [n=37] patients revealed significantly higher frequency and intensity of CD38 expression in progressive group [40.5%] compared to indolent [11.9%] patients [p<0.05]. None of the other membrane antigens were differentially expressed in these two groups of patients. Our results obtained in an Asian ethnic population confirm and extend previous findings obtained from Western populations regarding the association of CD38 expression and disease progression in B-CLL