الفهرس 
Introduction and Aim of the work
Chapter (1): Hematopoietic malignanciesOnly 14 pages are availabe for public view
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Abstract
Aim of the work
- Assess the expression of cyclin D1 gene in different hematopoietic malignancies (Acute myelogenous leukemia, chronic myelogenous leukemia, acute lymphoblastic leukemia, and chronic lymphocytic leukemia and Non Hodgkin lymphomas).
- compare it with some clinical and laboratory data.
Summary and Conclusion
The cyclin D1 oncogene product which derived from Prad-1/bel -1 locus on chromosome 11q13 is a major regulator of G-S transition of the cell cycle . Aberrantly expressed cyclin D1 has been implicated in the pathogenesis of several types of human neoplasm. High expression of cyclin D1 protein can differentiate mantle cell lymphoma from other B-cell neoplasm. Also, it indicates poor prognosis in childhood ALL and NHL.
In order to provide this background, this study had been carried on 50 patients suffering from malignant blood diseases and ten apparently healthy subjects as control. The patients and control were classified into :
І - Group І (Control group):
They were ten apparently healthy subjects.
П - Group П ( leukemic group ):
This group consists of 20 patients suffering from leukemia. This group was sub-classified into two groups:
1-Group Пa (myeloid leukemia group):
Ten patients with myeloid leukemia, divided into Group Пa1 (5 patients with AML) & Group Пa2 (5 patients with CML).
2-Group Пb (lymphoid leukemia group):
Ten patients with lymphoid leukemia, divided into Group Пb1 (5 patients with ALL) & Group Пb2 (5 patients with CLL).
Ш - Group Ш ( NHL group ):
This group consists of 30 patients with NHL. This group was sub-classified into two groups:
1-Group Шa (NHL with B.M. infiltration ) :
Thirteen patients suffering from NHL with B.M. infiltration.
2- Group Шb (NHL without B.M. infiltration):
Seventeen patients suffering from NHL with B.M. infiltration.
All patients were diagnosed on the bases of clinical features, cell morphology in peripheral blood film and B.M, cytochemistry for some cases, and histopathological analysis of lymph node biopsy in NHL cases.
All patients and controls were subjected to :
1. Complete history taking and clinical examination
2. Routine laboratory investigations including : complete blood count, B.M examination, LDH &ALP
3. Special investigations including detection of cyclin D1 mRNA by RT-PCR
І – Clinical data:
- In the present study, there was definite male predominance in all groups.
- Hepatomegaly was found in 40% of group Пa, 40% of group Пb, 46% of group Шa and 29.5% of group Шb.
- Splenomegaly was found in 70% of group Пa, 70% of group Пb, 61.5% of group Шa and 41.2% of group Шb.
- Lymph node enlargement was found in 40% of group Пa, 70% of group Пb, 100% of group Шa and 82.4% of group Шb.
- Purpura was found in 20% of group Пa, 10% of group Пb, 23% of group Шa and 0% of group Шb.
П- Routine laboratory data:
- Regarding the Hb level, there was very highly significant decrease in Hb level in group П and group Ш with mean ± SD (9.4 ± 1.8) in group П (leukemic group) and (9.1 ± 2.0) in group Ш (NHL group), 60% of leukemic patients and 73.3% of NHL patients present with Hb level < 10 g /dl.
- Regarding WBCs count, mean ± SD was 47.5±70.7 in group П and 10.1±8.7 in patients with NHL. There was significant increase in WBCs count in group Пa1 with P value = 0.042. In group Пa2, their was significant increase in WBCs count with P value = 0.011. In contrast their was significant decrease in WBCs count in group Пb1 with mean ± SD 3.8±1.9 & P value = 0.014. In group Пb2, their was significant increase in WBCs count with P value = 0.006.
- Regarding platelet count, there was very highly significant decrease in platelet count in group Пa1 with P value = 0.0001. Also, there was highly significant decrease in platelet count in group Шa (NHL with BM infiltration) with P value = 0.007.
- Regarding ALP level, mean ± SD was 147.3 ± 73.8 in group П & 117.5 ± 70.7 in group П. There was significant elevation in ALP level in group Пa1, group Пa2 & group Пb2, and very highly significant elevation in ALP level in group Пb1 P value = 0.0001.
- Regarding LDH level, 65% of patients had increased serum LDH. In group П (leukemic group) LDH mean ± SD was 1184.6 ± 992.0. Their was significant elevation in LDH level in group Пa1, group Пb2 and very highly significant elevation in LDH level in group Пa2 and group Пb1. In group Шa their was highly significant elevation in LDH level with with P value = 0.003.
Ш- Special investigations(detection of cyclin D1 mRNA by RT-PCR):
In this study, cyclin D1 expression was positive in 40 % of group П (leukemic group), 84.6 % of group Шa (NHL with BM infiltration) and 41.2 % of group Шb (NHL without BM infiltration). Group Шa showed higher cyclin D1 gene expression than group Шb.
There was no statistically significant difference between cyclin D1 positive and negative cases in all groups of the study as regards clinical and studied routine laboratory data except with LDH which was highly significant, as high results of LDH was associated with cyclin D1 positive, especially in group Пa, in which there was highly significant increase in LDH level associated with cyclin D1 gene expression (P=0.007).
Conclusion
Cyclin D1 gene expression appears to be an important diagnostic marker in different hematopoietic malignancies.
Recommendations
- Further work is needed to evaluate the diagnostic value of cyclin D1 gene over expression in different hematopoietic malignancies especially ALL and NHL.
- Follow up study is recommended for patients with hematopoietic malignancies to clear up the role of cyclin D1 gene expression as a prognostic factor after treatment.