title: High levels of CD20 expression predict good prognosis in chronic lymphocytic leukemia.
abstract: Heterogeneity of CD20 expression exists in chronic lymphocytic leukemia (CLL), therefore, we explored the prognostic significance of CD20 expression in Chinese patients with CLL. Multiparameter flow cytometry was used to detect the expression of CD20 in CD5(+) CD19(+) cells. In 172 CLL patients, the median expression percent of CD20 was 97.82% (range, 0-100), and the median mean fluorescence intensity (MFI) of CD20 in CLL cells was 731.45 (range, 0.00-9071.90). The percentage of CD20(+) cells in the patient group with mutated variable region of immunoglobulin genes (IGHV) was higher than in the non-mutant IGHV group (mean, 92.1% vs 80.4%, P < 0.001). There were no differences in the MFI of CD20(+) cells in all prognostic factor groups. Representation of the data using a receiver operating characteristic plot reflected separation between the two IGHV groups, with an area under the curve of 0.661 (95% confidence interval, 0.569-0.753). At the cut-off value of 60.3% for percentage of CD20, the sensitivity and specificity were 90.00% and 38.46%, respectively. Patients whose percentage of CD20 antigen was above 60.3% had longer treatment-free survival (hazard ratio, 0.452; 95% confidence interval, 0.232-0.884, P = 0.020). Percentage and MFI of CD20 were the variables not associated with treatment-free survival by multivariate Cox regression analysis (P < 0.05). High level of CD20 expression in de novo CLL appears to be associated with a good prognosis.
authors: Department of Hematology, First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.
authors: Cheng
authors: C
authors: Fang
authors: Yun
authors: Y
authors: Zhuang
authors: Li
authors: L
authors: Wang
authors: Lei
authors: L
authors: Fan
authors: Yu-Jie
authors: YJ
authors: Wu
authors: Run
authors: R
authors: Zhang
authors: Zhi-Jian
authors: ZJ
authors: Zou
authors: Li-Na
authors: LN
authors: Zhang
authors: Shu
authors: S
authors: Yang
authors: Wei
authors: W
authors: Xu
authors: Jian-Yong
authors: JY
authors: Li
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018951:Antigens, CD20 / Q000096:biosynthesis* / Q000235:genetics / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000096:biosynthesis* / Q000235:genetics / Q000378:metabolism; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve
chemical_list: D018951:Antigens, CD20; D014408:Biomarkers, Tumor
references: Ann Hematol. 2012 Jul;91(7):997-1005
references: 22249209
references: Blood. 1997 Jun 1;89(11):3960-6
references: 9166833
references: Leuk Res. 2008 Jul;32(7):1071-7
references: 18035414
references: Leuk Res. 2011 Nov;35(11):1432-5
references: 21840049
references: Cancer Sci. 2013 Aug;104(8):996-1001
references: 23659384
references: Blood. 2006 Nov 15;108(10):3302-4
references: 16896151
references: Nat Rev Cancer. 2010 Jan;10(1):37-50
references: 19956173
references: Br J Haematol. 2003 Mar;120(6):1017-25
references: 12648072
references: Blood. 2011 Sep 29;118(13):3470-8
references: 21765022
references: Br J Haematol. 2008 Apr;141(1):36-40
references: 18324964
references: Blood. 2008 Jun 15;111(12):5446-56
references: 18216293
references: Expert Opin Biol Ther. 2011 May;11(5):551-7
references: 21385115
references: Leuk Res. 2009 Feb;33(2):237-43
references: 18674817
references: J Clin Pathol. 1998 May;51(5):364-9
references: 9708202
references: Blood. 2009 Jun 18;113(25):6330-7
references: 18703706
references: Haematologica. 2010 Feb;95(2):324-8
references: 19773266
references: Leuk Res. 2010 Dec;34(12):1670-3
references: 20674973
references: Leuk Res. 2008 Oct;32(10):1491-8
references: 18359082
references: Blood. 2009 Apr 16;113(16):3773-80
references: 19029441
references: N Engl J Med. 2004 Aug 26;351(9):893-901
references: 15329427
references: Ann Oncol. 2011 Sep;22 Suppl 6:vi50-4
references: 21908504