EXPRESSÃO DOS MARCADORES CD56, CD16 E CD57 NA AVALIAÇÃO PROGNÓSTICA DE PACIENTES COM LEUCEMIA LINFÓIDE AGUDA NO ESTADO DO MARANHÃO

Abstract

The acute lymphoblastic leukemia (ALL) is characterized by abnormal proliferation of immature lymphoid cells and represents the most common cancer in children. The evaluation of prognostic factors in patients with ALL enables the implantation of different therapeutic approaches. The aberrant expression of markers CD56, CD57 and CD16 may be a way to assess this prognosis. The objective of this study was to characterize patients with ALL and to evaluate the prognostic influence of aberrant expression of markers CD56, CD16 and CD57 in ALL. 44 patients treated at the Maranhense Oncology Institute Aldenora Bello in Sao Luis - MA were evaluated, from March 2010 to October 2011. Patients were diagnosed with ALL according to the morpho-cytochemical and immunophenotype criteria. The expression of markers was determined by flow cytometry and clinical data were obtained through chart review. Two groups were divided as the expression or not of these markers and compared in relation to prognostic variables. The average of age in the sample was 6,28 years, with a predominance of males (60,0%). The average of blasts counted in bone marrow (BM) and peripheral blood (PB) was 77,0 and 39,6, respectively. The L1 morphology of the blasts from BM was the most frequent (80,0%). The profile of the blood count at diagnosis indicated: 24.061 leukocytes/mm3; 56.510 platelets/mm3 and 8,0 g/dL hemoglobin. According to the classification GBTLI-99, 60,0% of the patients were in low risk of recurrence group and in the end of the induction phase of treatment (D29), 70,0% of the patients had remission. The patients with ALL T had mean of age (10,6 years; p = 0,0204) and leukometry (48.200/mm3; p = 0,0167) significantly higher than patients with ALL B. 80,0% of the patients expressed the CD56 marker and no patient expressed CD16 and/or CD57 markers. Patients who did not express the marker CD56 had age significantly higher those who expressed (9,3 years; p = 0,0353). For patients with ALL B, the average of blasts from PB of patients who expressed the CD56 marker was higher than those not expressed (41,1; p = 0,0226). It is concluded that CD56 expression characterizes a worse prognosis for patients with ALL B, due to a significantly higher average of blasts counted in PB found in our study. However, a greater number of cases and a longer observation time would be needed to better emphasize this evidence.