Residual Bone Marrow T & NK-Cells at Diagnosis in Pediatric Pre-B-ALL: A Case-Control Study

Mature bone marrow T lymphocytes and NK may have a special relevance in the control of the malignant growth. We aimed to assess the percentage of the residual BM T-cells, (T-helper -T-cytotoxic- NKT) and the NK cells of childhood precursor B-lymphoblastic leukemia (B-ALL) as an indicator of innate and adaptive immunity in these patients. This study was conducted on 40 B-ALL patients, and 40 apparently healthy matched children served as a control group. The flow cytometry was used to assess the percentage of the residual BM T-cells (T-helper, T-cytotoxic and NKT), and the NK cells. Compared with the control group, the percentage of the residual BM T-cells, its subtypes (T-helper, T-cytotoxic), and NKT cells in addition to the NK cells was significantly decreased in Group IA, and Group IB, but there was no significant difference between Group IA and Group IB in all studied parameters. In terms of the CD4/CD8 ratio, there was a significant increase in Group IA as compared to the control group (P < 0.026), but there were no significant statistical differences in CD4/CD8 ratio between Groups IB, and the control. Likewise, in CD4/CD8 ratio between groups IA, and Groups IB (P > 0.05). The percentage of NK, and NKT cells shows a significant increase in Hepatomegaly and Splenomegaly, as compared to non-Hepatomegaly and non-Splenomegaly patients of Groups IB (P < 0.05). However, there was a significant increase in statistical differences in the percentage of NKT cell between non-Splenomegaly, as compared to Splenomegaly patients of Group IA (P < 0.05). Additionally, there is a negative correlation between B.M Blast% to CD4/CD8 ratio and NK%, but there is no significant correlation between B.M Blast% to NK T% in the group 1 A.