Flowcytometric Measurement of CD5, CD23, and CD38 expression as a diagnostic and prognostic markers in CLL patients

Background: B-Chronic lymphocytic leukemia (B-CLL) is a monoclonal malignancy characterized by an accumulation of terminally differentiated small and anergic B lymphocytes in the blood, bone marrow and other tissues. CLL is typically characterized by CD5+, CD23+, CD22 -, CD79b-, with weak expression of surface Ig. CD5 also is expressed in B1 subset of human B -lymphocytes. Mature B cell malignancies, such as B-cell chronic lymphocytic leukemia, are mostly CD5 +. CD23 promotes the activation and proliferation of normal B lymphocytes and has an important role in the process of malignant transformation in B- CLL.CD38 is expressed on the surface of leukemic cells in a significant percentage of patients with B-cell chronic lymphocytic leukemia (B-CLL).Its expression has prognostic value in CLL. The current immunophynotype antigens is used to diagnosed as CLL cases, and by using the modern multicolor Flow Cytometry, which made it possible to determine the expression of several such antigens on specific cell populations of the CLL cases. Objectives : To measure the expression of CD5, CD23, and CD38 antigens on the B-cells of morphologically diagnosed CLL cases, and showing their correlation with the hematological parameters, and with each other. Material and methods : A prospective cohort study including 20 patients including 11 females and 9 males morphologically diagnosed with CLL. The patients were attending the National Center of Hematology, Al-Yarmouk teaching hospital for the period from November 2012 to March 2013. A total of 2 ml of venous blood were collected from all patients who were selected randomly with respect to age, sex, duration and stage of the disease. The diagnosis was done by Iraqi J. Hematology, July 2015, vol.4, Issue1 16 measuring and calculating the total number of blood cells and lymphocytes and hemoglobin and other by using autoanalyzer blood counter, then flowcytometry was used to measure the appearance of antigens surface CD5 and CD23 CD38. Results: The mean of age of all patients included was 61.95+8.88 SD, and a range of (45-75) years old. There were 11 (55%) males patients, the most common symptoms of patients is an enlarged spleen (45%). 85% of patients who were in Binet stage C, the most advanced stage of the disease. Within Binet stage C there was 94.1% percent of patients showed moderate intensity expression of CD5 and CD23, while 64.7% of them for CD38. There was no statistical significance of CD5, CD23 in relationship to age, hemoglobin or platelet, while CD5 showed a significant relationship with lymphocytes count and the total number of white blood cells (P