The Expression of Human Telomerase Reverse Transcriptase Gene and Its Activity in Patients with B-Cell Chronic Lymphocytic Leukemia and Its Impact on Clinical Staging

BACKGROUND: The B-Cell chronic lymphocytic leukemia is a commonest leukemia in elderly individuals characterized by progressive accumulation of mature lymphocyte in bone marrow and peripheral blood that tend to be immortal. The identification of human telomerase reverse transcriptase (hTERT) has been correlated with disease aggressiveness in malignancies. The previous researchers showed that the hTERT expression could serve as a molecular prognostic marker for B-CLL patients. However, due to the disease differences in prevalence and aggressiveness between the western and eastern countries, there is still a need to see the correlation of hTERT in B-CLL patients of the eastern world.

AIM: To test the quantitative assessment of hTERT gene expression in B-CLL patients and its prognostic value in correlation with clinical staging of disease in Iraqi patients.

PATIENTS & METHODS: we used the TRAP assay to assess the hTERT gene expression in mononuclear blood cells from 43 B-CLL patients.

RESULTS: The hTERT gene expression was detected in 79.1% of B-CLL patients and no positive expression in control group (P=0.001). The hTERT gene expression tends to be significantly higher in advanced B-CLL stage (P=0.0001). Also, the expression was higher among elderly patients, patients with lower hematological parameters, patients with splenomegaly or hepatomegaly, patients with a history of hypertension or diabetes mellitus, and patients with high immunophenotype score.

CONCLUSION: Our research suggests that the hTERT expression could serve as a prognostic marker for Iraqi patients with B-CLL as well as western countries.