The Role of Expression of Lymphoid Enhancer-Binding Factor-1 (LEF-1) in Patients with Chronic Lymphocytic Leukemia

Abstract

Background: Lymphoid Enhancer-Binding factor-1 (LEF-1) is a 48-kD nuclear protein that is expressed in pro-B cells and mature T cells but not in mature B cell. LEF-1 binds to a functionally important site in the T-cell receptor alpha (TCR .t ) enhancer and confers maximal enhancer activity; LEF-1 belongs to a family of regulatory proteins that share homology with high mobility group protein-1 (HMG1). Lymphoid Enhancer-Binding factor-1 LEF-1 is sufficient to differentiate CLL/SLL from other small B-cell lymphomas and may serve as a useful tool in the diagnosis of CLL/SLL, LEF-1 is highly associated with CLL/SLL among small Bcell lymphomas and therefore can serve as a useful immunehisto-chemistry (IHC) marker for diagnosis and differential diagnosis of CLL/SLL. Aim of the Study:Our aim is to evaluate the role of Lymphoid Enhancer-Binding factor-1 (LEF-1) expression by flow cytometry in patients with chronic lymphocytic leukemia. Methods and Material:This study was carried out on 45 newly diagnosed B-CLL patients attending the hematology oncology clinic of Tanta University Hospitals. The patients were selected for the study on the basis of standard clinical, hematological and immune phenotypic criteria for diagnosis of CLL, In addition to 15 apparently healthy subjects serving as healthy control group. Subjects included in this study were classified into the following groups: Chronic Lymphocytic Leukemia Group I: Included 45 patients with chronic lymphocytic leukemia.Group I: Healthy Control Group. This group included 15 apparently healthy subjects.Results: There was no significant correlation between LEF-1 expression and age and sex, there was a significant negative correlation between LEF1 expression and Hb and platelet count, there was a significant positive correlation

Lymphoid enhancer binding factor-1 (LEF1): as a prognostic factor in patients with Chronic lymphocytic leukemia

“…One case had Immune hemolytic with positive direct antiglobulin (Coomb's) test. In El-Sharnouby et al, [17], HB (g/dl) ranged from 7.8 to 11.2 with a MeanSD (9.10.88). PLT count ranged from 21 to 356 (109 / L) with a MeanSD (139.887.8) 6 cases with mild thrombocytopenia > 100, 8 cases with moderate thrombocytopenia 50 -99 and 5 cases with marked thrombocytopenia < 50.…”

“…Thrombocytopenia could be due to immune phenomenon, splenic pooling and bone marrow failure. In El-Sharnouby et al, [17], PLT count ranged from 68 to 155 (109 / L) with a MeanSD (101.322.04). Immunophenotyping is a very important tool in CLL diagnosis; CD19 (87.5%), CD5 (93.8%), CD20 (87.5%), CD23 (90.4%), CD79b (46.9%), FMC7 (12.5%).…”

“…LEF1's activity in particular cancer cell types, such as chronic lymphocytic leukemia (CLL), Burkitt lymphoma (BL), acute lymphoblastic leukemia (ALL), oral squamous cell carcinoma (OSCC), and colorectal cancer (CRC), makes it a valuable biomarker in predicting patient prognosis [15] [16]. This study was carried out on patients newly diagnosed as b-cell chronic lymphocytic leukemia, In El-Sharnouby et al, [17] the study was carried out on newly diagnosed B-CLL patients, in Wu et al, [18] CLL patients were either previously untreated or had received no treatment for at least 6 months before the investigation, while in Erdfelder et al, [19] the study included untreated patients, and patients with a maximum of up to three prior treatment regimens. According to clinical data of our CLL patients; 53.1% had PS (0) and 46.9% had PS (1).…”

“…in Gutierrez et al, [20] stage 0 (30.9%), stage 1 (26.1%), stage 2 (7.1%), stage 3 (9.8%), stage 4 (4.7%), and (21.4) ND, not determined. Also El-Sharnouby et al, [17], and Erdfelder et al, [19] included all stages. Medical history and clinical examination of patients reveled easy fatigability in 20 patients (62.5%), LN enlargement was positive in 28 patients (87.5%), Splenomegaly was positive in 20 patients (62.5%), Left hypochondrial pain was positive in 3 patients (9.4%) ,Hepatomegaly was positive in 11 patients (34.5%) while B symptoms (fever, night sweats, and weight loss) were positive in 1 patients (3.1%).In El-Sharnouby et al, (2018) [18], lymphadenopathy was observed in 41/45 (91.1%), splenomegaly was observed in 27/45 (60%) and hepatomegaly was observed in 11/45 (24.4%).…”

“…Laboratory data showed that TLC (109 / L) (9 -234) with a MeanSD (79.160.5), absolute lymphocytic count (6.5 -216 (109 / L)) with a MeanSD (69.956.8), Lymphocytes percentage ranged from 45% to 96% with a MeanSD (7613). ALC wasn't so high in some case, yet clonality approved by flow cytometry In El-Sharnouby al., [17], TLC (109 / L) (15 -503) with a MeanSD (79.8105.2), absolute lymphocytic count (13.5 -407 (109 / L)) with a MeanSD (65.984.6). HB (g/dl) ranged from 5.3 to 13.5 with a MeanSD (9.82.3), 23 cases (71% of patients) presented with anemia, 9 cases with mild anemia > 10 g/dl , 7 cases with moderate anemia 8 -9.9 g/dl and 7 cases with marked anemia < 8 g/dl .We should consider late presentation of many of our cases.…”