title: CD49d expression is an independent risk factor of progressive disease in early stage chronic lymphocytic leukemia.
abstract: 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 >or=30% (54/140, 38.6%) associated with proliferation markers, namely CD38 >or=30% (p=3.9 x 10(-6)), LDH (p=0.007) and beta2-microglobulin (p=0.020). Univariate log-rank analysis identified CD49d >or=30% as a risk factor of treatment free survival (p=8.3 x 10(-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 >or=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 >or=30% consistently identified a subset of patients with short treatment free survival. Our observations indicate CD49d >or=30% as a new marker for the initial prognostic assessment of Binet A chronic lymphocytic leukemia.
authors.affiliation: Division of Hematology, Department of Clinical and Experimental Medicine & BRMA, Amedeo Avogadro University of Eastern Piedmont, via Solaroli 17, 28100 Novara, Italy. rossidav@med.unipmn.it
authors.forename: Davide
authors.initials: D
authors.lastname: Rossi
authors.forename: Antonella
authors.initials: A
authors.lastname: Zucchetto
authors.forename: Francesca Maria
authors.initials: FM
authors.lastname: Rossi
authors.forename: Daniela
authors.initials: D
authors.lastname: Capello
authors.forename: Michaela
authors.initials: M
authors.lastname: Cerri
authors.forename: Clara
authors.initials: C
authors.lastname: Deambrogi
authors.forename: Stefania
authors.initials: S
authors.lastname: Cresta
authors.forename: Silvia
authors.initials: S
authors.lastname: Rasi
authors.forename: Lorenzo
authors.initials: L
authors.lastname: De Paoli
authors.forename: Chiara Lobetti
authors.initials: CL
authors.lastname: Bodoni
authors.forename: Pietro
authors.initials: P
authors.lastname: Bulian
authors.forename: Giovanni
authors.initials: G
authors.lastname: Del Poeta
authors.forename: Marco
authors.initials: M
authors.lastname: Ladetto
authors.forename: Valter
authors.initials: V
authors.lastname: Gattei
authors.forename: Gianluca
authors.initials: G
authors.lastname: Gaidano
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D018450:Disease Progression; D005260:Female; D006801:Humans; D039441:Integrin alpha4 / Q000097:blood*; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000097:blood* / Q000473:pathology*; D008297:Male; D009367:Neoplasm Staging; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors
chemical_list: D014408:Biomarkers, Tumor; D039441:Integrin alpha4