Clinico-prognostic implications of increased levels of soluble CD54 in the serum of B-cell chronic lymphocytic leukemia patients. Results of a multivariate survival analysis.
OBJECTIVE
Although less specific than sCD23, sCD54 levels have clinico-prognostic relevance in B-cell chronic lymphocytic leukemia (CLL). Since serological markers are now emerging as potentially important in CLL, we tried to verify whether sCD54 might complement clinical stages.


METHODS
Serum levels of sCD54 were determined at the time of diagnosis in 115 previously untreated CLL patients. Results were correlated with clinicobiological parameters as well as with survival.


RESULTS
Life-expectancy was significantly shorter in patients with higher serum levels of sCD54 (p < 0.001); however, in a Cox's multivariate survival analysis, the only variables which entered the regression model at a significant level were bone marrow (BM) histology (p = 0.03) and lymphocyte doubling time (LDT) (p = 0.04). Interestingly, when LDT was excluded from analysis the only significant variables were clinical stages (p < 0.05) and sCD54 (p < 0.05). These results suggest that sCD54 and LDT give similar prognostic information.


CONCLUSIONS
In CLL, sCD54 is a reliable prognostic parameter whose value is independent of clinical stages. When investigated in relation to clinical outcome, serum levels of sCD54 were able to predict progression to a more advanced clinical stage. On the basis of these data, an integrated clinico-biological classification which separates intermediate risk into two prognostic subgroups is proposed.
Molica
S
S
Divisione di Ematologia, Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro, Italy.
Levato
D
D
Dell' Olio
M
M
Cascavilla
N
N
Matera
R
R
Minervini
M
M
Dattilo
A
A
Carotenuto
M
M
Musto
P
P
D000368:Aged; D014408:Biomarkers, Tumor; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000097:blood* / Q000276:immunology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis
D014408:Biomarkers, Tumor; D018799:Intercellular Adhesion Molecule-1