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Abstract
CD40 positive expression may be a good prognostic factor
in ALL.
Detection of CD40 expression at diagnosis is of high
clinical relevance, because its expression has a direct cosequence
for treatment stratification, being associated with good prognosis.
The present study aimed to assess CD40 expression
frequency in patients with ALL, and to evaluate its association
with the different demographic, clinical and laboratory data, as
well as its relation to disease outcome.
The current study was carried out on 40 newly diagnosed
ALL patients. All patients were subjected to complete history
taking, thorough clinical examination and laboratory
investigations including: complete hemogram, bone marrow
aspiration with examination of Leishman-stained peripheral blood
and bone marrow smears, immunophenotyping and detection of
the level of CD40 expression by flowcytometry.
CD40 expression was not associated with any of the
studied demographic, clinical or laboratory variables.
No statistically significant associations were elicited
between CD40 expression and any of the studied prognostic
factors of patients. However, a significant positive association was
detected between patients who responded to chemotherapy and
Summary and Conclusion
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positive CD40 expression. So, CD40 could be regarded as an
independent good prognostic factor for the prediction of good
response to chemotherapy.
Concerning the clinical outcome of the studied patients,
CD40 negative patients showed more incidence of resistance to
chemotherapy and death than CD40 positive patients, while CD40
positive patients were more liable to achieve complete remission.
Moreover, there was a highly statistically significant
associations between CD40 expression and with a longer OST
and DFS, so, CD40 could be regarded as an independent
prognostic parameter for relapse free survival.
Finally, these findings imply that CD40 positive expression
confers good prognosis in ALL patients.
from this study, we conclude that CD40 is an
independent prognostic factor for relapse free survival, and also
an independent prognostic factor for the prediction of good
response to chemotherapy, since CD40 positive patients are
more liable to achieve complete remission, while CD40
negative ones are more susceptible to death or
chemotherapeutic resistance.