Author(s)

Ahmad Baraka¹, Shereen El Shorbagy², Ola M. Elfarargy^2*, Rasha Haggag², Lobna A. Abdelaziz³, Salah F. Elsayed⁴, Khaled A. Elbana^4*

¹Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
²Medical Oncology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
³Clinical Oncology & Nuclear Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
⁴Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Background: High levels of MCL-1 and BCL-2 proteins have been found in Chronic Lymphocytic Leukemia (CLL), and inversely correlated with response to treatment. BCL-2/Bax ratio is the main director of apoptosis in CLL. The study aimed to clarify the prognostic role of MCL-1, BCL-2 and BCL-2/ Bax ratio in B-CLL. Patients & method: Estimation of MCL-1, BCL-2 and Bax expressions by a flow cytometry in 45 B-CLL patients and the prognostic value of these markers were correlated with other well-known established prognostic markers and treatment response. Results: MCL-1 was expressed in 60% of cases while BCL-2 was expressed in 82.2% of cases. MCL-1 expression was significantly high in male gender, short lymphocyte doubling time (LDT), and high expression of CD 38 (p < 0.001). High (Serum LDH, serum β2M, CD38 expression), low ZAP-70 expression, splenomegaly and higher Rai stage were significantly increased in patients with high expression of BCL-2 (p < 0.001); also a significant decrease in (HB level, platelet count), and increase in serum LDH, serum β2M, high C-D38 expression, low ZAP-70 expression, the poor cytogenetic and splenomegaly in patients with high expression of BCL-2/ Bax ratio (p < 0.001). Among the 39 patients who started treatment when indicated responding patients had statistically significant lower BCL-2/Bax ratio than non-responding patients, although their lower mean of MCL-1 and BCL2 expressions values were insignificant. In conclusion: MCL-1, BCL-2 expressions and BCL-2/Bax ratio could be useful potential predictive and prognostic markers in B-CLL.

Myeloid Cell Leukemia 1, B-Cell Lymphoma 2, BAX, B-Cell Chronic Lymphocytic Leukemia

Baraka, A. , Shorbagy, S. , Elfarargy, O. , Haggag, R. , Abdelaziz, L. , Elsayed, S. and Elbana, K. (2017) Prognostic Significance of Apoptosis Regulators in B-Cell Chronic Lymphocytic Leukemia. Journal of Cancer Therapy, 8, 360-385. doi: 10.4236/jct.2017.84032.