Haematologica (Oct 2008)

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

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

DOI
https://doi.org/10.3324/haematol.13103
Journal volume & issue
Vol. 93, no. 10

Abstract

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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=3.9×10−6), 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=4.7×10−4), 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