Expression of B-cell activating factor in acute lymphoblastic leukemia patients

Introduction Acute lymphoblastic leukemia (ALL) is a biologically heterogeneous disorder needing determination of morphologic, immunologic, cytogenetic, biochemical, and molecular genetics characterizations of lymphoblasts to establish diagnosis. Microenvironmental cues play critical roles in cancer biology and malignant cells are responsive to multiple extrinsic factors. There is emerging evidence that B-cell activating factor (BAFF) is a critical factor for the growth and survival of both normal and malignant clones of B-cells and can augment tumor cell growth. There is evidence that B-lineage neoplasms have aberrant expression of BAFF. Objectives The aim of this study was to evaluate serum BAFF levels to assess its prognostic impact on ALL and correlate it with mortality. Patients and methods The study was conducted at Ain Shams University on 40 ALL pediatric and adult patients, in addition to 20 controls. Patients underwent detailed history and clinical examination, bone marrow examination, and evaluation of serum BAFF levels using enzyme-linked immunosorbent assay. Thereafter, they were assessed for treatment response and patients’ mortality on day 28 from induction of chemotherapy and after 6 months, respectively. Results We found a statistically significant lower BAFF levels among controls compared with the patient group, in which there was no significant difference between pediatric and adult subgroups. High serum BAFF was significantly correlated to patients’ poor treatment response but not mortality. Conclusion High BAFF in our studied patients may be explained by its role in augmenting B-cell tumor growth. In our study, we found that BAFF had no relation with disease outcome. This may be caused by the limited number of patients included. Assessment of BAFF level at the time of diagnosis may be a predictor for response to treatment, as we found a significant relation between BAFF level and response to treatment. This finding recommends that patients with high BAFF level at the time of diagnosis be subjected to intensified course of therapy.