Levels of Circulating Adhesion Molecules in Patients with Acute Leukemia.
El-Aggan HA, El-Badawi RH.
Department of Hematology, Medical Research Institute, Alexandria University.

The spread of leukemia extends from mobilization of leukemic blast cells from the bone marrow to extramedullary tissue infiltration. Migration of leukemic blasts may be regulated by activated endothelial cells via endothelial adhesion molecules. In this study levels of soluble intercellular adhesion molecule-1 (ICAM-1) and L-selectin were analysed in 35 patients with acute leukemia (25 with acute myeloid leukemia; AML and 10 with acute lymphoblastic leukemia; ALL) at diagnosis and in complete remission. The concentrations of these adhesion molecules were significantly elevated compared to controls. Repeated measurements in 13 patients in complete remission showed normal range levels. Furthermore, L-selectin but not ICAM-1 level correlated with peripheral leucocyte and blast cell counts. The classification of patients according to the French-American-British cooperative group criteria showed the subgroups to differ in levels of ICAM-1 and L-selectin. The highest levels were measured in acute lymphoblastic (ALL), myelomonocytic (M4) and monocytic (M5) i.e. leukemia subtupes with high incidence of extramedullary blast cell infiltration. These results revealed that adhesion molecules may have an important role in the regulation of leukemic cell adhesion to endothelium and may be related to subtype of leukemia. It could be concluded that monitoring of the levels of circulating adhesion molecules is valuable in assessing or predicting the course of leukemic activity.

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