Lymphocyte Subsets in Acute Myeloid Leukemia and their Prognostic Significance

Abstract

Acute myeloid leukaemia (AML) represents a group of clonal hematopoietic stem cell disorders in which both failure to differentiate and overproliferation of the stem cells result in the accumulation of myeloblasts with loss of normal hematopoietic function. There are currently several characteristic factors as advanced age, cytogenetic and performance status that are commonly used as predictors of clinical outcome Purpose: To study the lymphocyte subsets in newly diagnosed acute myeloid leukemia patients and their relation to standard prognostic factors. Patients and Methods: This study was conducted on 33 newly diagnosed adult patients with AML. They were recruited from the Hematology Oncology Unit, Ain-Shams University Hospitals, from July 2017 till June 2018, with a male to female ratio of 1.2: 1. A consent was taken from all patients. Their ages ranged from 19- 81 years, with a mean of 41.5 ± 17 years. Results: This cohort study was conducted on 33 newly diagnosed AML patients attending the hematology and oncology unit of Ain-Shams University Hospital. The diagnosis of AML was based on standard morphology, cytochemical analysis, immunophenotyping (flow-cytometry) and cytogenetic analysis (FISH). Conclusion: This study found that total BM lymphocytes percentage > 5% and T-cytotoxic > 48% are indicators of good prognosis with accepted sensitivity and specificity. Also in correlating different lymphocytes subsets in different AML subtypes; We found that M5 (AML-NOS) showed increase in NK cells. NKT cells percentage were increased in AML-RGA t(8; 21). T helper cells were increased in M4 (AML-NOS), t(8; 21) and t (9; 11) (AML-RGA). T cytotoxic cells were higher in M2 (AML-NOS) and in t(8; 21)(AML-RGA). While regarding B cells percentage, they showed their highest percentages in AML-RGA t(8; 21)