Diagnostic and clinical significance of Argyrophilic proteins in patients with acute leukemia

ABSTRACT

The number [amount] of Argyrophilic proteins [AgNORs] were estimated in bone marrow smears of thirty-six patients with acute leukemia at initial diagnosis 24 children [10 males 14 females] and 12 adults [6 males and 6 females] as well as 12 matched controls. The purpose of the present work was to study the possible relation of AgNORS to immunophenotypic markers and clinical outcome. Silver staining of AgNORS was applied to bone marrow smears, and immunophenotyping was done by FACS flow cytometry. Statistically significant difference in mean AgNORS count/nucleus was observed in patients versus control [p<0.05], and a different staining pattern was observed in acute lymphoblastic leukemia [ALL] [fine dots] versus acute myeloid leukemia [AML] patients [coarse dots]. Positive correlation was found between AgNORS and bone marrow blast percent, while negative correlation was found with age, hemoglobin concentration and platelet count. Strong AgNORS staining was associated with immaturity markers and poor response to treatment. Eighty percent [80%] of AML and 70% of ALL patients with mean AgNORS<2.5 achieved complete remission. Determination of AgNORS has a major predictive value and adds an additional tool to differentiate ALL from AML smear Hence, it should be included in the diagnostic and prognostic workup of patients with acute leukemia