Background: B-chronic-lymphocytic-leukemia (B-CLL)is a heterogeneous illness with a varied clinical history. Some individuals don't require therapy while others have an aggressive disease. Researchers discovered several prognostic biomarkers to help clinicians make decisions about whose patients will be in need to start treatment. Developing immunophenotyping markers such as CD69 and other serum markers such as TK and VEGF are evolving over time.
Objective: This study aimed to assess relevance of CD69 as prognostic indicator in CLL cases and its association with Vascular-endothelial-growth factor (VEGF) and Thymidine-kinase (TK) activity.
Methods:  The research had 80 patients with B-CLL and 17 healthy controls. All subjects underwent routine laboratory investigations, flowcytometric analysis of CLL panel, CD38 and CD69 and TK activity and VEGF level by ELISA.
Results: CD69 %, VEGF and TK were significantly higher in patients than in controls. Patients who required treatment had significantly higher CD69% and elevated levels of VEGF and TK than patients who were untreated. Correlation between CD69% with different parameters revealed significant positive correlation between CD69% and age, modified Rai staging, TLC, lymphocyte, B2 microglobulin, LDH, Coombs`test, receiving chemotherapy, CD 38/19%, VEGF and TK. CD69% at cut off levels of > 45% can significantly detect time to start chemotherapy with sensitivity and specificity of 88.89% and 77.27%. Regression analysis showed that age, modified Rai staging, lymphocyte count and HB level were independent variables that can predict CD69 expression. Conclusions: CD69, TK and VEGF could be considered as poor prognostic markers adding a new option for development of new prognosis score system.