The comparative study of angiogenesis in chronic lymphocytic leukemia and control group and its correlation with bone marrow infiltration pattern and clinical stage

Abstract

Background: Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults. In our study, bone marrow angiogenesis was evaluated in CLL patients and control group and relationship between microvessel density and the bone marrow infiltration pattern and clinical stage. Materials and Methods: In this cross-sectional and case-control study, 130 paraffin- embedded blocks of bone marrow were used. Bone marrow specimens from 75 patients with CLL and 55 controls were studied. They were evaluated by immunostaining with CD34 marker. Slides stained with anti-CD34 were examined at 100x magnification for detection of "hot spots," which are areas with highest vascularization. Three such hotspots were chosen and numbers of microvessels were counted in each of these hotspots at 400x magnification. The MVD was expressed as the average of the total count of vessels. Results: Bone marrow microvessel density (MVD) in patients with CLL (32.22 -/+ 12.81) was significantly higher than that in controls (14.57 -/+ 9.33) (P-value=0.000). There was a significant positive correlation between MVD and the Rai stage system (r =0.425, P-value= 0.000). The correlation between MVD and the Pattern of bone marrow infiltration Non-diffuse and Diffuse was not significant (r = -0.149, P-value= 0.203). Conclusion: Angiogenesis in patients with chronic lymphoid leukemia (CLL) is significantly higher than the control group and strongly significant and positive relationship with the Rai system. The available data suggest that angiogenesis plays an important role in the pathogenesis of CLL.Understanding their roles help in designing new therapeutic strategies for CLL.