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Year : 2020  |  Volume : 9  |  Issue : 1  |  Page : 34-40

BAX/BCL2 ratio in chronic lymphocytic leukemia and its association with ZAP-70 expression and other clinicopathological parameters

1 Department of Laboratories, Al Fallujah Teaching Hospital, Al Anbar, Iraq
2 Department of Pathology, Mustansiriyah University, College of Medicine, Baghdad, Iraq

Correspondence Address:
Dr. Rihab Malik Rahid
Department of Laboratories, Al Fallujah Teaching Hospital, Al Anbar
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijh.ijh_2_20

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BACKGROUND: Chronic lymphocytic leukemia (CLL) is a heterogeneous disease with a highly variable clinical course and outcome. Many clinical and biological characteristics have been used to classify patients with CLL into different subgroups of variable prognosis. Many studies have reported that in CLL, the interaction between pro- and antiapoptotic BCL2 family members influences the sensitivity to cytotoxic drugs and affects survival and overall outcome. OBJECTIVES: The aim of the study was to assess BCL2 and BAX expression and BCL2/BAX ratio relation to other known prognostic markers (Binet stage, absolute lymphocyte count, lymphocyte percentage in bone marrow [BM], and ZAP-70 and CD38 expression). PATIENTS AND METHODS: The study analyzed the expression of BCL2 and BAX, BCL2/BAX ratio, and ZAP-70 in the BM biopsy of 42 randomly selected CLL patients. RESULTS: BCL2 was positively expressed in 92.9% of CLL cases, significantly associated with Binet stage of disease (P = 0.04), ZAP-70 (P = 0.001) but not with CD38, and also significantly correlated with absolute lymphocyte count (P = 0.015) and lymphocyte percentage in BM (P = 0.017). BAX was positively expressed in 64.3% of CLL cases; there was no significant association between BAX with Binet or with other assessed prognostic factors (except with ZAP-70, P = 0.001). BCL2 and BAX were significantly correlated with each other (P = 0.001). BCL2/BAX ratio was not associated with any prognostic parameters we assessed. CONCLUSION: We may conclude that we may consider BCL2 as simple informative tool to assess disease activity while BAX and BCL2/BAX ratio alone are of no prognostic value in prediction of disease course.

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