Abstract
BACKGROUND: The B-Cell chronic lymphocytic leukemia is a commonest leukemia in elderly individuals characterized by progressive accumulation of mature lymphocyte in bone marrow and peripheral blood that tend to be immortal. The identification of human telomerase reverse transcriptase (hTERT) has been correlated with disease aggressiveness in malignancies. The previous researchers showed that the hTERT expression could serve as a molecular prognostic marker for B-CLL patients. However, due to the disease differences in prevalence and aggressiveness between the western and eastern countries, there is still a need to see the correlation of hTERT in B-CLL patients of the eastern world.AIM: To test the quantitative assessment of hTERT gene expression in B-CLL patients and its prognostic value in correlation with clinical staging of disease in Iraqi patients.PATIENTS & METHODS: we used the TRAP assay to assess the hTERT gene expression in mononuclear blood cells from 43 B-CLL patients.RESULTS: The hTERT gene expression was detected in 79.1% of B-CLL patients and no positive expression in control group (P=0.001). The hTERT gene expression tends to be significantly higher in advanced B-CLL stage (P=0.0001). Also, the expression was higher among elderly patients, patients with lower hematological parameters, patients with splenomegaly or hepatomegaly, patients with a history of hypertension or diabetes mellitus, and patients with high immunophenotype score. CONCLUSION: Our research suggests that the hTERT expression could serve as a prognostic marker for Iraqi patients with B-CLL as well as western countries.
Highlights
Chronic lymphocytic leukemia is a type of cancer affecting the white blood cells in adults (Hoff brand & Moss, 2016)
The human telomerase reverse transcriptase (hTERT) gene expression was detected in 79.1% of B-CLL patients and no positive expression in control group (P=0.001)
We used hTERT detection to assess the telomerase activity by TRAP assay in both B-CLL patients and control individuals, and it showed that the hTERT expression detected in 34 (79.1%) patients and it was significantly higher than the control group which did not show any hTERT expression and this result is higher than Tchirkov A (Tchirkov, 2004) result which showed 59% of B-CLL patients expressed hTERT and this disparity may be related to difference between the methods that used for hTERT detection
Summary
Chronic lymphocytic leukemia is a type of cancer affecting the white blood cells in adults (Hoff brand & Moss, 2016) It is characterized by progressive accumulation of mature lymphocyte in bone marrow and peripheral blood. Chronic lymphocytic leukemia is the most common type of leukemia accounting for 60% of cases, and it is the most common in the West counters (Teras et al, 2016) representing about 25% of all leukemia in adult’s age above 50 years; in rare cases, it can be present in younger age (Kipps et al, 2017) Telomerase reverse transcriptase it is a catalytic subunit of the enzyme telomerase, which, together with the telomerase RNA component (TERC), comprises the most important unit of the telomerase complex (Kirkpatrick, 2001; Skvortsov, 2011). Due to the disease differences in prevalence and aggressiveness between the western and eastern countries, there is still a need to see the correlation of hTERT in B-CLL patients of the eastern world
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