CD49d as Prognostic Marker in B-Cell Chronic Lymphocytic Leukemia in Correlation with the Expression of CD38, ZAP-70 and Clinical Binet Stage


ABSTRACT:BACKGROUND: Chronic lymphocytic leukemia (CLL) is a heterogeneous disease with highly variable clinical course and outcome. A number of clinical and biological features have been used to separate patients with CLL into subgroups with different prognoses. CD49d, CD38 and ZAP-70 expressions have shown to independently predict prognosis in CLL.OBJECTIVE: To assess the expression of CD49d in CLL patients and correlates them with CD38 and ZAP-70, and with clinical Binet staging.PATIENTS AND METHODS: This study was conducted on 30 newly diagnosed CLL patients. Diagnosis was based on lymphocyte count of > 5×109/L and immunophenotyping. The expression of CD49d, CD38 and ZAP-70 were investigated using four-color flow cytometer.RESULTS: The expression of CD49d, CD38 and ZAP-70 were detected in 60%, 56.7% and 30% of patients, respectively. The correlations between the expression of CD38 and both CD49d and ZAP-70 were both statistically significant (P= 0.002). A higher significant correlation was found between CD49d and ZAP-70 (P= 0.001). There was a statistically significant relationship between CD49d expression and Binet staging (P =0.035), while no significant relations were found between both CD38 and ZAP-70 and Binet staging (P >0.05). CD49d was more sensitive (76.5%) than the other two markers in prediction the intermediate and advanced stage with accuracy of 70%.CONCLUSION: CD49d expression was higher than that of CD38 and ZAP-70 and was significantly correlated with both of them. The adverse prognostic impact of CD49d was demonstrated by higher expression levels in intermediate and advanced-stage patients. CD49d has the highest sensitivity and accuracy with considerable specificity when compared with CD38 and ZAP-70, rendering CD49d a reliable biomarker for prognostication of CLL.