SERUM VASCULAR ENDOTHELIAL GROWTH FACTOR AND CD34 ENDOTHELIAL CELL MARKER IN LYMPHOID MALIGNANCIES

Angiogenesis plays a major role in the development and progression of haematological malignancies. Vascular endothelial growth factor (VEGF) is a major pro-angiogenic factor that adversely affects the prognosis of patients with haematological malignancies via enhancing microv ess el formation and tumor growth. The aim of the work is to study serum VEGF level and CD34 endothelial cell marker a indicator of microvessel density (MVD) in patients with lymphoid malignancies. Serum VEGF level was determined by enzyme immunoassay (EIA) method and CD34 endothelial cell marker was determined in bone marrow section by immunohistochemical staining using anti-CD34 antibodies in 60 patients with lymphoid malignancies and 12 patients with non-malignant haematological disorders. Patients included 36 patients of non-Hodgkin lymphoma (NHL), 12 patients with chronic lymphocytic leukemia (CLL) and 12 patients with Hodgkin s disease (HD. The control group included 6 patients with autoimmune haemolytic anaemia and 6 patients with hypersplenism. Serum VEGF level was highly significantly elevated in patient groups compared to control group (F =4.58, P 0.01) and was correlated with LDH level (r = 0.29, P 0.05) and CD34 staining (r = 0.37, P 0.01). Serum VEGF level was significantly different in different IP I (international prognostic index) classes in NHL patients (F = 2.84, P 0.05) but was non-significantly different in different subtypes of NHLs (F = 0.78, P 0.05). CD34 staining (MVD) was highly significantly elevated in patient groups compared to control group (F = 2.48, P 0.01) and was correlated with leucocytic count (r = 0.35, P 0.01), bone marrow infiltration (r = 0.34, P 0.01), LDH (r = 0.36, P 0.01) and VEGF (r = 0.37, P 0.01). CD34 staining (MVD) was significantly different in different IP I classes in NHL patients (F = 3.50, P 0.05) but was non-significantly different in different subtypes of NHLs (F = 0.73, P 0.05). Patients with increased CD34 staining (MVD) showed significantly lower survival in Kaplan-Meier Curve (P 0.05). Enhanced angiogenesis in patients with lymphoid malignancies is adversely related to patient survival. Serum VEGF and immunohistochemical staining for CD34 endothelial cell marker are valuable prognostic indicators in lymphoid malignancies