HOME HELP FEEDBACK TABLE OF CONTENTS ARCHIVE SUBSCRIPTIONS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Rossi et al. - Supplementary appendix Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Rossi, D. Articles by Gaidano, G. PubMed PubMed Citation Articles by Rossi, D. Articles by Gaidano, G.

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

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=3.9x10^–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=4.7x10^–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.