الفهرس 
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Abstract
The non-Hodgkin lymphomas (NHLs) are colonal lymphoid tumer they are diverse group of blood cancers that include any kind of lymphoma except Hodgkin’s lymphomas.
Human CD44 gene is located at the short arm of chromosome 11.As an adhesion molecule, the effects of CD44 are in many ways, for example, participating in lymphocyte homing, T-lymphocyte activation, promoting the adherence between fibroblast, lymphocyte and extracellular material (ECM), participating in signal transmission, renewing the composition of interstitial tissue, accommodating drug absorption and drug sensitivity, and participating in pseudopod formation and cell migration .
All the biological properties of CD44 are essential to the physiological activities of normal cells, but they are also associated with the pathologic activities of cancer cells. Elevated CD44 expression was correlated with poor prognosis in many malignancies, such as lung cancer, ovarian cancer, breast cancer, colorectal cancer, gastrointestinal neuroendocrine tumor, and so on. In recent years, scholars pay more attention to the association with CD44 and hematological malignancies .
Our study included 50 persons, divided as follows: Patients group splitted into two groups: Group I (20 patients) included stage I, II, III non Hodgkin lymphoma patients, Group II (30 patients) comprised stage IV non Hodgkin lymphoma patients, and controls involved 20 apparently healthy persons.
In our results, comparing the control with different stages of NHL regarding level of CD 44 expression we can see that CD 44 expression was low in stage I,II,III and control groups and it was significantly higher in stage IV NHL.
Our study proves that the most significant factors in differentiating different stages of NHL within studied factors are age of the patients, level of FMC7 expression, platelet count and level of CD 44 expression.
In another hand we correlate between CD44 and other standard diagnostic and prognostic markers of NHL. Also CD44 is expressed in many hematological malignancies, the level of which is associated with clinical condition and prognosis.
It is believed that the value of CD44 and its monoclonal antibodies in the diagnosis, metastasis, prognosis and therapy of hematological malignancies will be fully recognized and accompanied by the deep basic and clinical researches.
Conclusion
In conclusion, strong CD 44 expression appears to be a powerful prognostic indicator in adult NHL with no difference between male and female patient. It is associated with standard poor prognostic markers such as bone marrow infiltration, anemia thrombocytopenia and organomegally. Analysis of CD44 expression in addition to other standard prognostic markers at diagnosis may prove the way to improve outcome.
RECOMMENDATIONS
In view of the present study, we recommend the following:
Bone marrow biopsy and immunohistochemistry should be done for every case of non Hodgkin lymphoma whether for staging or for confirming the diagnosis.
Further studies on a wide scale of NHL patients for accurate assessment of incidence and prognostic value of CD44 expression.
Further studies are needed to decide an optimal approach to analyze CD44 expression in clinical samples.
Standard prognostic markers, Immunophenotyping using routine panel in addition to CD44 and cytogenetic studies should be complementary done at diagnosis of NHL for accurate assessment of patient’s outcome.
The anti-CD44 monoclonal antibodies can effectively suppress the proliferation and induce differentiation or apoptosis of leukemic cells in some subtypes. Studies on CD44 antibodies therapy are just in the phage of primary experiments, and have not reached consensus, so further studies need to be made on this aspect.