Details

Autor(en) / Beteiligte

• Rossi, Davide
• Zucchetto, Antonella
• Rossi, Francesca Maria
• Capello, Daniela
• Cerri, Michaela
• Deambrogi, Clara
• Cresta, Stefania
• Rasi, Silvia
• De Paoli, Lorenzo
• Bodoni, Chiara Lobetti
• Bulian, Pietro
• Del Poeta, Giovanni
• Ladetto, Marco
• Gattei, Valter
• Gaidano, Gianluca

Titel

CD49d expression is an independent risk factor of progressive disease in early stage chronic lymphocytic leukemia

Ist Teil von

• Haematologica (Roma), 2008-10, Vol.93 (10), p.1575-1579

Ort / Verlag

Pavia: Haematologica

Erscheinungsjahr

2008

Quelle

MEDLINE

Beschreibungen/Notizen

• 1 Division of Hematology, Department of Clinical and Experimental Medicine and BRMA, Amedeo Avogadro University of Eastern Piedmont and Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara 2 Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico, I.R.C.C.S., Aviano 3 Division of Hematology, Department of Experimental Medicine and Oncology, University of Turin, Turin 4 Department of Hematology, S. Eugenio Hospital and University of Tor Vergata, Rome, Italy Correspondence: Davide Rossi, M.D., Division of Hematology, Department of Clinical and Experimental Medicine & BRMA, Amedeo Avogadro University of Eastern Piedmont, via Solaroli 17, 28100 Novara, Italy. E-mail: rossidav{at}med.unipmn.it Identification of prognosticators for Binet A chronic lymphocytic leukemia is important for selecting patients with dismal prognosis. We analyzed CD49d expression in 140 consecutive Binet A chronic lymphocytic leukemia. At diagnosis, CD49d 30% (54/140, 38.6%) associated with proliferation markers, namely CD38 30% ( p =3.9 x 10 –6 ), LDH ( p =0.007) and β2-microglobulin ( p =0.020). Univariate log-rank analysis identified CD49d 30% as a risk factor of treatment free survival ( p =8.3x10 –5 ), time to progression to a more advanced stage ( p =4.7 x 10 –4 ), and time to lymphocyte doubling ( p =0.009). Multivariate analysis selected CD49d 30% as an independent treatment free survival predictor after adjustment for biological (HR 2.28; 95% CI 1.71–4.45, p =0.015) and both biological and clinical variables analyzed together (HR 3.33, 95% CI 1.61–6.90, p =0.001). Within Binet A subgroups harboring favorable biological variables (IGHV homology <98%, favorable karyotype, CD38 <30%, ZAP70 <20%) or clinical variables, CD49d 30% consistently identified a subset of patients with short treatment free survival. Our observations indicate CD49d 30% as a new marker for the initial prognostic assessment of Binet A chronic lymphocytic leukemia. Key words: chronic lymphocytic leukemia, CD49d, Binet A, prognostic factor.