International Journal of Hematology and Oncology 2021, Vol 31, Num 4 Page(s): 138-145
THE SIGNIFICANCE OF ARGYROPHILIC NUCLEOLAR ORGANISER REGIONS (AGNORS) IN PEDIATRIK ACUTE LYMPHOBLASTIC LEUKEMIA

TÜRKAN PATIROĞLU1, MUSA KARAKÜKCÜ1, ALİ İLTEN1, NALAN İMAMOĞLU1

Erciyes Üniversitesi, Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları AD, Pediatrik Hematoloji BD

Keywords: all, cell proliferation, nors proteins, silver staining
In this study, the silver-staining of the nucleolar organizer regions (NORs) was performed in pediatric patients with acute lymphoblastic leukemia (ALL) to verify the role of cell proliferation in predicting complet remission and survival. The importance of NORs values as a prognostic parameter was also compared with that of other well-established pretreatment prognostic features. Bone-marrow aspiration smears of 20 pediatric cases with ALL (10 male, 10 female and mean age 8.00±4.25 years) were stained with the argyrophilic method at the diagnosis, and 3th, 6th, 9th and 12th months during remission. Hundred cells were examined for each patients and each smears. The mean NORs count (NORsc) and mean (nucleolar organizer regions surface / total nuclear surface x 100) value (NORss/TNs) for each case were calculated. At diagnosis, the NORsc and NORss / TNs value for the whole series were 3.30 + 0.86 and 4.77 + 1.15 respectively. At the complete remission, NORsc and NORss / TNs value were 1.23 + 0.20 and 3.45 + 0.87 respectively (p<0.001). The NORss / TNs values of three cases and NORsc of two cases were greater at follow up than remission values. Medullary relapse was observed in these cases nine months after diagnosis. There was a relationship between NORss / TNs value and other prognostic factors such as blast morphology, leukocyte count, whereas the relationship between the NORss / TNs value and immunophenotyping of ALL, sex of patients were not significant. We found that there was significant difference only in diagnosis NORsc value for leukocyte count. In conclusion, NORs analysis is a suitable method to assess cell proliferation in bone marrow aspirate and can predict complete remission and duration of remission.