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ORIGINAL ARTICLE
Year : 2013  |  Volume : 38  |  Issue : 1  |  Page : 7-12

Prognostic significance of flow cytometric quantification of circulating endothelial cells in chronic lymphocytic leukemia


1 Department of Clinical Pathology, Hematology Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
2 Department of Internal Medicine, Hematology Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Correspondence Address:
Deena Samir Eissa
Department of Clinical Pathology, Ain Shams University Hospitals, Ramses St, Abbasia, 11566 Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.7123/01.EJH.0000423009.85761.ea

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Background

Accumulating evidences have supported the role of angiogenesis in the pathogenesis and progression of chronic lymphocytic leukemia (CLL). Detection of peripheral blood circulating endothelial cells (CECs) by flow cytometry is proposed to be a noninvasive indirect marker of angiogenesis. This work aimed to quantify CECs and endothelial progenitor cells (EPCs) by flow cytometry in patients with newly diagnosed CLL compared with healthy individuals, study their relationship with established risk predictors of the disease, and assess their prognostic significance.

Materials and methods

Flow cytometric quantification of CECs and EPCs was carried out for 50 newly diagnosed B-CLL patients and 20 healthy controls. Patients were followed up for assessment of the time to first treatment, response to therapy, and disease outcome.

Results

Patients with CLL had higher counts of CECs (median, 24.6×106/l) and EPCs (median, 22.7×106/l) compared with the controls (median, 2.8 and 1.9×106/l for CECs and EPCs, respectively; P<0.001). CLL patients were subdivided according to the median values of CECs and EPCs into high and low CEC and EPC subgroups. Although high levels of CECs and EPCs were not related to established risk predictors of CLL (P>0.05), they were significantly related to higher white blood cell counts (P<0.001), shorter time to first treatment, and poor response to therapy (P<0.05).

Conclusion

This study shows that flow cytometric detection of peripheral blood CECs is a feasible indicator of abnormal angiogenesis in CLL that might be utilized as a biologic prognostic marker of a more aggressive disease course with a poor clinical outcome.



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