Circulating endothelial progenitor cells as a prognostic marker in childhood acute lymphoblastic leukemia

Abstract

Introduction Angiogenesis has been associated with the growth, the dissemination, and the metastasis of many tumors; it may also enhance the survival, the proliferation, and the chemoresistance of leukemic blasts cells. Circulating endothelial cells are proposed to be a noninvasive marker for the assessment of angiogenesis. The aim of this work was to evaluate, for the first time, the number of circulating endothelial progenitor cells (CEPCs) in the peripheral blood in childhood acute lymphoblastic leukemia (ALL) as a prognostic marker. Materials and methods We quantified the number of CEPCs by flow cytometry in 50 childhood ALL patients at the time of diagnosis and in 30 healthy controls. Results We found, statistically, that the CEPC number was significantly higher in the patient group than in the control group. There was a significant association between a high CEPC number with a higher total leukocytic count, the high-risk patient group, and a poor response to therapy, but no statistically significant difference regarding the hemoglobin concentration, the platelet count, cytogenetic analysis, immunophenotyping, and the French-American-British classification. Conclusion The number of CEPCs is higher in childhood ALL patients and significantly linked to a high-risk disease status and chemoresistance.