title: HLA-G expression as a prognostic indicator in B-cell chronic lymphocytic leukemia.
abstract: BACKGROUND
  The expression of human leukocyte antigen (HLA)-G was studied in certain malignancies and its role in escaping from immunosurveillance in cancers was proposed since HLA-G is a non-conventional HLA class I molecule that protects the fetus from immunorecognition during pregnancy. Some particles involved in the regulation of an immune system might represent prognostic value for B-cell chronic lymphocytic leukemia (B-CLL). The identification of novel prognostic factors in B-CLL may help define patient subgroups that may benefit from early therapeutic intervention.
  
  
  OBJECTIVE
  To evaluate the prognostic significance of HLA-G expression in B-CLL patients and its relationship with other well-established prognostic markers.
  
  
  METHODS
  Thirty B-CLL patients diagnosed by clinical, morphological and immunophenotyping criteria were studied for HLA-G expression by flow cytometry. The relationship between HLA-G expression and some known prognostic markers was evaluated.
  
  
  RESULTS
  HLA-G was expressed in 36.7% of CLL patients at diagnosis, with a mean expression level of 35.31 ± 12.35%. A significant association between HLA-G expression and common prognostic markers of progressive disease was detected. The group of patients with positive HLA-G expression showed significantly higher absolute lymphocyte counts and serum levels of LDH and β2-microglobulin, lower platelet counts, positive CD38 expression and advanced stages of Binet clinical staging.
  
  
  CONCLUSIONS
  The present study demonstrated that HLA-G expression correlates with prognostic markers of a poor B-CLL outcome, mainly Binet clinical staging and CD38 expression by B-CLL cells, which indicates that this parameter may play a role as an important prognosticator of disease progression and consequently targeted therapy in B-CLL.
authors.affiliation: Department of Clinical Pathology, Tanta University, Faculty of Medicine, Tanta, Egypt.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Attia
authors.forename: Nahla A
authors.initials: NA
authors.lastname: Nosair
authors.forename: Amro
authors.initials: A
authors.lastname: Gawally
authors.forename: Gamal
authors.initials: G
authors.lastname: Elnagar
authors.forename: Eid M
authors.initials: EM
authors.lastname: Elshafey
mesh_terms: D051997:ADP-ribosyl Cyclase 1 / Q000097:blood; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood / Q000276:immunology; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005434:Flow Cytometry; D059951:HLA-G Antigens / Q000097:blood*; D006801:Humans; D016130:Immunophenotyping; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000097:blood* / Q000276:immunology*; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood; D008875:Middle Aged; D011379:Prognosis
chemical_list: D014408:Biomarkers, Tumor; D059951:HLA-G Antigens; D008562:Membrane Glycoproteins; C498154:CD38 protein, human; D051997:ADP-ribosyl Cyclase 1