The significance of plasma L-selectin in acute myeloid leukemia: A case control study

Background: Acute Myeloid Leukaemia (AML) is a heterogeneous group of haematological malignancies which are characterized by malignant proliferation and the accumulation of immature myeloid progenitor cells in the bone marrow. A clinical history of myelodysplasia, the assessment of the morphology of the blast cells, cytogenetics and immunophenotyping are the important criteria which have been used in the recent WHO classification to prognosticate as well as to guide the therapy of AML. L-selectin is a cellular soluble adhesion molecule and it mediates the initial tethering of the normal leucocytes to the endothelial surface . An increase in the plasma L-selectin levels in cases of acute leukemia has been observed in many studies, but till date, this biochemical parameter has not been used as a marker in monitoring leukaemic patients. This study was conducted to compare the L-selectin levels in fresh and treated cases of AML and also with healthy controls. The assessment of the plasma L-selectin levels is expected to add more information about the disease activity and it could also serve as an adjunct to the existing immunological and genetic markers. Aims, Settings and Design: This case control study aimed at estimating the plasma L-selectin levels in cases of acute myeloid leukaemia in comparison with those in normal healthy adults. Further, we assessed the plasma L-selectin levels during the active and the remission phases of AML. Materials and Methods: 20 freshly diagnosed and 20 treated cases of AML were included in the study group from the Haemato Oncology Department of our institution. Forty healthy people who were the staff members of the hospital were included as the controls. The quantitation of L-selectin was done by a highly sensitive immunometric ELISA assay (Manufacturers; Bendermed systems, Vienna, Austria), by using monoclonal antibodies against L-selectin. The statistical significance was calculated by using the Bonferroni T-test and Pearson’s correlation analysis. Results: There was a statistically significant (p=<.001) increase in the plasma L-selectin levels in the freshly diagnosed AML patients as compared to the control group. The plasma L-selectin levels in the patients who were in remission matched with that of the controls. Conclusions: Plasma L-selectin may be used as a marker of the disease activity in AML patients. It may also be used to assess the remission status of these patients.