The Prognostic Value of Apoptotic Marker (CD95) in Adult Acute Leukemias

Abstract

Fas-mediated cell death is involved in drug-induced apoptosis in various cell types. Hence, failure of apoptosis could lead to chemoresistance in acute leukemia. The participants of this study were 80 adult acute leukemia patients classified as follows: 40 acute myeloid leukemia (AML) patients, 40 acute lymphoblastic leukemia (ALL) patients. In addition, 10 healthy controls were also included in the study. Fas expression was measured using flow cytometry. The mean value of Fas expression by blast cells from AML patients at diagnosis was 41.72 ± 10.3%. AML patients were divided into the Fas-positive group [30 patients (72.5%)] and the Fas-negative group [10 patients (27.5%)]. The mean value of expression increased significantly in M5 (52.91 ± 11.3%) with highly significant differences (P < 0.001) between Fas expression levels in different FAB subtypes of AML. The mean value of Fas expression in ALL patients was 43.87± 11.5%. 23 (57.5%) patients were positive for Fas expression, whereas 17 (42.5%) were negative. Fas expression was positive in 14/24 (63.2%) precursor B-ALL patients and in 12/16 (84.6%) T-ALL patients. The mean value of Fas expression was significantly higher (P = 0.039) in T-ALL (55.15 ± 7.8%) in comparison with precursor B-ALL (34.47 ± 5.76%). The mean value of Fas expression by blast cells from AML and ALL, patients at diagnosis was 41.72± 10.3 and 43.87 ± 11.5. We can conclude that Fas receptor expression on blast cells from ALL and AML patients could serve as an independent prognostic factor.