Vol. 6, Issue 1, Part A (2024)

Acute lymphoblastic leukemia (ALL) is the most prevalent pediatric cancer, comprising about 25% of all cancer diagnoses in children under 15 years. This study investigates the expression of CD34, a marker associated with hematopoietic stem and progenitor cells, in pediatric ALL and its correlation with clinical outcomes at the Central Teaching Hospital of Pediatrics in Baghdad. Despite its recognized role in hematological malignancies, the relationship between CD34 expression and clinical outcomes in pediatric ALL remains inadequately explored, particularly in the Iraqi context. We conducted a cross-sectional analysis involving 60 children aged 12 years or younger, newly diagnosed with ALL and not yet undergoing chemotherapy. Flow cytometry was utilized to assess CD34 expression alongside clinical data, including symptoms, hematological parameters, and treatment responses. Our findings revealed CD34 positivity in 75% of the patients, significantly correlated with age, risk group, and immunological classification, with higher positivity rates among children under 5 years (75.6%) and B-ALL patients (89.0%). Notably, CD34 expression was associated with the presence of a mediastinal mass and CNS involvement, highlighting its potential clinical relevance. Although no significant differences were found in other hematological parameters, the study indicates that CD34 may serve as a valuable prognostic marker in pediatric ALL, particularly for risk stratification. This research underscores the need for region-specific studies to enhance understanding of prognostic factors in pediatric cancers, aiming to optimize treatment strategies and improve survival rates in the Iraqi population. Further investigation into the molecular and cytogenetic profiles of ALL patients is warranted to establish comprehensive prognostic frameworks that could facilitate personalized therapy approaches.