Abstract
Angiogenesis and proliferation as measured by microvessel density (MVD) and proliferation index (PI) are essential correlates of malignancy. The aim of our study was to evaluate difference between these values in AML and ALL and also to study the modulation in these parameters following achievement of remission in acute lymphoblastic leukemia. Differences between adult and adolescent cases of acute leukemia in relation to these values were also studied. We also tried to assess the relationship between angiogenesis and proliferation. Fifty-five patients with acute leukemia were included in the study. Trephine biopsies were immunostained with CD34 and factor VIIIrAg to demonstrate angiogenesis measured as MVD. Immunostaining with PCNA and Ki-67 was done to study proliferation. We found a significant increase in MVD and PI in cases when compared with controls (P < 0.0001). In addition cases with ALL had a significantly higher MVD compared to those with AML (P < 0.01). The patients with ALL who went into remission showed a significant reduction in MVD; PI remained high. The cases which did not achieve remission showed no significant reduction in either MVD or PI. All adolescent cases of ALL were similar to adults with respect to MVD and PI.
Highlights
Angiogenesis is a very important biologic correlate of malignancy whose role is well established in solid tumors and hematological malignancies
There are a significant number of studies which have shown increase in angiogenesis and/or its mediators in patients with acute leukemia [4, 6, 7]
Our study is on nonpediatric cases of acute leukemia, whereas most of the published series on therapy related changes in angiogenesis and proliferation are on childhood acute leukemia
Summary
Angiogenesis is a very important biologic correlate of malignancy whose role is well established in solid tumors and hematological malignancies. There are few studies showing the effect of chemotherapy on angiogenesis in acute leukemia [1]. In spite of extensive studies, the utility of angiogenesis as a prognostic tool in acute leukemia has not been entirely established. Growth of a tumor as measured by the proliferation index is shown to be an independent prognostic factor in acute leukemia [2]. The relationship between proliferation and angiogenesis has been shown in myeloma [3]. We studied the relation between angiogenesis and proliferation and if they were individually dependent on the immunophenotypes of acute leukemia
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