الفهرس 
List of TablesOnly 14 pages are availabe for public view
 |  | from | 162 |  |  |
| | | from | 162 | | |
Abstract
The primary aim of the present study was to assess the expression level of Annexin A1 in Adult AML. In addition, we tried to identify the relations between Annexin A1 and clinicopathological features and other prognostic markers to explore the usefulness of its expression level in predicting prognosis in adult AML.
Sixty Egyptian patients with AML were included in this study and were recruited from the Hematology Unit of Ain Shams University Hospitals, from February 2017 to August 2018.
Patients with AML had significant higher mean Annexin A1 expression than mean Annexin A1 expression in control on D0.
The mean Annexin A1 level in the favourable cytogenetics group was significantly higher than the mean Annexin A1 level in the unfavourable cytogenetics group.
There was no significant relation between Annexin A1 expression and age, gender, presence or absence of hepatomegaly, splenomegaly or enlarged lymph nodes.
There was no significant correlation between Annexin A1 expression and WBCS count, Hb. concentration, PLT count, ESR 1st hr., blast cells no. in blood or bone marrow.
There was no significant relation between Annexin A1 expression and FAB subtypes.
Correlation studies between Annexin A1 levels at the time of diagnosis and flow cytometry of BM showed significant positive correlation between level of Annexin A1 and level of MPO and CD64 in AML patients and significant negative correlation with level of CD14. No correlation was detected between Annexin A1 levels at the time of diagnosis and levels of CD markers of BM in AML patients as CD34, CD13, CD33, CD117, HLADR, CD15, CD5, CD7 and CD19.
Annexin A1 was positive (> 20% of cells) in 46 (76.66%) AML patients and negative in 14 (23.33%) AML patients.
There was a significant difference between Annexin A1 positive group and Annexin A1 negative group of AML patients as regards different outcomes. In Annexin A1 positive group, 24 (52.17 %) AML patients achieved CR, 7 (15.22%) patients failed to achieve CR and 15 (32.6%) patients died. While, in Annexin A1 negative group, 2 (14.29%) AML patients achieved CR, 4 (28.57%) patients failed to achieve CR and 8 (57.14%) patients died. Highest mean Annexin A1 expression was in group of patients who had complete remission.
There was significant difference in mean overall survival (OS) between AML patients with positive Annexin A1 expression (mean ± SD: 8.68 ± 1.20 months) and AML patients with negative Annexin A1 expression (mean ± SD: 4.16 ± 1.53 months). High Annexin A1 expression associated with longer overall survival.
CONCLUSION AND RECOMMENDATIONS
• In conclusion, our findings documented that Annexin A1 is significantly expressed in de novo Egyptian AML (AML) patients and its expression associated with favorable prognostic impact on clinical outcome in the form of high CR rate and longer overall survival.
• We suggest that high expression level of Annexin A1 may identify distinct group of Egyptian AML patients with favorable prognosis. It may serve as prognostic predictor of outcome and response to chemotherapy and a potential target for therapeutic intervention.
• This study had several limitations as the inclusion of a small number of patients. We could not assess the effects of various genetic mutations, including mutations in NPM1, FLT3-ITD, and CEBPA.
• Based on the present study, we recommend multicentric studies that may include large number of patients with various genetic mutations and longer follow up period and include patients who underwent hemopoietic stem cell transplantation to establish the role of Annexin A1 and for better management of AML patients.