الفهرس 
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Abstract
Acute lymphoblastic leukemia (ALL) is a malignant disorder of lymphoid progenitor cells that proliferate and replace the normal hematopoietic cells of the bone marrow. These lymphoblasts replacing the normal bone marrow elements result in a marked decrease in the production of normal blood cells.
There are many prognostic factors in ALL such as age, sex, race, leukemic burden, laboratory criteria (initial TLC, hemoglobin level, platelet count, immunophenotyping and chromosomal abnormalities). Assessment of these factors is mandatory for therapeutic assignment.
CD27 is a member of the tumor necrosis factor family, is expressed on T cells, Nk cells and memory B cells. The interaction between CD27 and its ligand CD70 plays an important role in in the maturation and activation of these cells. It plays an important role in lymphoid differentiation and apoptosis, induced on normal B lymphocytes after antigenic challenge it is a marker of memory B cells.
Increased levels of sCD27 have been associated with immune activation in diseases such as AIDS, multiple sclerosis and systemic lupus erythromatosus
The present study aimed to assess CD27 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 response to therapy.
The current study was carried out on 30 newly diagnosed ALL patients & 20 healthy control. 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 CD27 expression by flowcytometry.
CD27 expression was not associated with any of the studied demographic or clinical data but was associated with some laboratory variables.
Sstatistically significant associations were elicited between CD27 expression and some of the studied prognostic factors of patients. In addition, a significant positive association was detected between patients who responded to chemotherapy and positive CD27 expression. So, CD27 could be regarded as a good prognostic factor for the prediction of good response to chemotherapy.
Concerning the clinical outcome of the studied patients, CD27 negative patients showed more incidence of resistance to chemotherapy than CD27 positive patients.
Detection of CD27 expression at diagnosis is of high clinical relevance, because its expression has a direct consequence for treatment stratification, being associated with good prognosis.
Finally, these findings imply that CD27 positive expression confers good prognosis in ALL patients.
from this study, we conclude that CD27 is a good prognostic factor, and also for the prediction of good response to chemotherapy, since CD27 positive patients are more liable to achieve good response to therapy, while CD27 negative ones are more susceptible to chemotherapeutic resistance.