KILLER IMMUNOGLOBULINE LIKE RECEPTOR GENE ANALYSIS IN CHRONIC LYMPHOCYTIC LEUKEMIA AND ITS RELATION WITH AUTOIMMUNITY

Year 2021, Volume: 84 Issue: 2, 227 - 236, 25.04.2021

Murat Özbalak Işıl Erdoğan Özünal Selin Berk Tuğrul Elverdi Ayşe Salihoğlu Ahmet Emre Eşkazan Ezgi Pınar Özbalak Cem Ar Şeniz Öngören Zafer Başlar Yıldız Aydın Seda Ekizoğlu Asuman Çelebi Ayşe Nur Buyru Teoman Soysal

https://doi.org/10.26650/IUITFD.2020.0037

Abstract

Objective: Our study was performed on 49 chronic lymphocytic leukemia (CLL) patients followed in the outpatient clinic of the Istanbul University Cerrahpasa Medical Faculty Department of Hematology. We aimed to analyze the relationship between autoimmune phenomena and CLL. Methods: Twenty-five CLL patients with and 24 CLL patients without autoimmune phenomenon were included. Thirty-two of them were male and 17 were female. No statistically significant difference in the median age at diagnosis (60 vs 64) and in the median follow-up time (59 months vs 71 months) was detected. The initial diagnostic parameters were similar. Results: In our autoimmune phenomenon cohort, the most frequent autoimmune disease was autoimmune hemolytic anemia (AIHA) followed by immune thrombocytopenia (ITP) and pure red cell aplasia (PRCA). The direct antiglobulin positivity at the time of diagnosis was increased in the autoimmune phenomenon group (p=0.024). Additionally, the stage of CLL in patients of the autoimmune phenomenon group was more advanced than the other group (p=0.04). Although the number of autoimmune phenomena was not high enough, the CD38 positive cell ratio over 30% in the peripheral blood was more frequent in PRCA group (p=0.008). Conclusion: We could not determine a relationship between autoimmunity in CLL and KIR genotypes. We believe that a new study in a larger cohort with superior technical conditions should be planned to find accurate responses to our study.

Keywords

Chronic lymphocytic leukemia, Killer immunoglobuline like receptor, autoimmunity, autoimmune hemolytic anemia, immune thrombocytopenic purpura, pure erythroid aplasia

KRONİK LENFOSİTİK LÖSEMİ TANILI HASTALARDA KİLLER İMMÜNOGLOBULİN LİKE RESEPTÖR GEN DÜZEYLERİ VE OTOİMMÜN OLAYLAR İLE İLİŞKİSİ

Abstract

Amaç: İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Hematoloji Polikliniği’nde takip edilen 49 Kronik Lenfositik Lösemi (KLL) hastası çalışmaya dahil edilmiştir. Çalışmanın amacı, çeşitli otoimmün hastalıklar ile ilişkisi gösterilmiş olan Killer Immunoglobuline Like Receptor (KIR) gen düzeylerini, otoimmün olay gözlenmiş ve gözlenmemiş KLL hasta grupları arasında karşılaştırmaktır. Gereç ve Yöntem: Bu doğrultuda otoimmün olay gözlenmiş olan 25 ve otoimmün olay gözlenmemiş 24 KLL hastası çalışmaya dahil edilmiştir. Hastaların 32’si erkek, 17’si kadındır. Otoimmün hastalık gözlenen grup ile otoimmün olay gözlenmeyen KLL grubu arasında tanı anındaki yaş (60 vs 64) ve ortanca takip süresi (59 ay vs 71 ay), tanı anındaki parametreleri istatistiki olarak benzerdir. Bulgular: Gözlenen en sık otoimmün olay otoimmün hemolitik anemi (OİHA) iken onu immün trombositopeni (İTP) ve saf eritroid aplazi (PRCA) takip etmiştir. Otoimmün olay gözlenmiş hastaların tanı anında direkt antiglobulin testi pozitiflik oranı, otoimmün olay gözlenmemiş KLL hastalarına göre artmış olduğu gözlenmiştir (p=0,024). Ayrıca otoimmün olay gözlenen hastaların tanı anında KLL hastalık evrelerinin daha ileri olduğu görülmüştür (p=0,04). Otoimmün olaylar kendi aralarında değerlendirildiğinde ise, sayı az olmasına karşın, PRCA’da çevresel kanda CD38 pozitif hücre oranının %30’un üstünde olma sıklığının arttığı gözlenmiştir (p=0,008). Sonuç: Çalışmamızda KIR genlerinin otoimmün olaylarla ilişkisi incelendiğinde, otoimmünite gözlenmeyen gruba göre herhangi bir istatistiki fark tespit edilememiştir. Daha iyi teknik şartlarda yeni çalışmalar yapılmasında fayda vardır.

Keywords

Kronik lenfositik lösemi, Killer immunoglobuline like reseptör, otoimmünite, otoimmün hemolitik anemi, immün trombositopenik purpura, saf eritroid aplazi

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