Prognostic Significance of Immune Function Parameters (CD4, CD8 and CD4/CD8 ratio) in Sudanese Patients with Chronic Lymphocytic leukemia

Background: Chronic Lymphocytic Leukemia (CLL) is a heterogeneous disorder with respect to its clinical course. Accurate identification of prognostic factors is becoming increasingly important in order to determine those patients requiring aggressive treatments. The Rai clinical staging systems is used to define disease extent and predict survival. Aim: to evaluate prognostic significance of CD4, CD8 and CD4/CD8 ratio in Sudanese patients with CLL. Method: We determined immune function parameter in 35 newly diagnosed patients with chronic lymphocytic leukemia (CLL) using flow cytometry and correlated these findings with the clinical data and the subsequent course of the disease. Results: The mean of (CD4/CD8) ratio of 35 patients were (27 males/ 8 females) with the CLL was (0.79±0.08) compared with the mean of 35 normal volunteer (1.96±0.5) (P.value 0.000), they were tested at the same period of time. The decrease of CD4/CD8 ratio observed in stage 0 to IV was statistically significant (P. value < 0.000). In clinical stage III and IV patients presenting with the advanced disease, those who subsequently had more severe course, were found to have at presentation significantly lower CD4/CD8 ratio. Conclusion: CD4/CD8 ratio was decreased in advanced form of chronic lymphocytic leukemia and this simple parameter of immune function seem to be have a huge prognostic value for patients with CLL.