title: Expression of CD56 is a risk factor for acute lymphocytic leukemia with central nervous system involvement in adults.
abstract: OBJECTIVE
  To gain further insights into the predisposing risk factors for central nervous system (CNS) involvement in patients with acute lymphocytic leukemia (ALL), the impact of CD56 expression in these patients was investigated.
  
  
  METHODS
  We reviewed the clinical features of CD56 expression in 588 consecutive ALL patients treated with systemic chemotherapy regimens between 2000 and 2014. The categorical data from CD56+ALL patients were compared with those from CD56-ALL patients.
  
  
  RESULTS
  Among the 588 patients studied, 18.9% showed CD56 expression. The expression was significantly associated with CD33+, CD10-, CD15+, TdT-, and CD5+immunophenotypes. After systemic chemotherapy, 8.8% patients showed CNS involvement, of which 3.2% exhibited combined recurrences and 5.6% exhibited isolated CNS involvement. The 5-year event-free survival was significantly lower for patients with CD56+immunophenotype compared with patients with CD56-immunophenotype (22.5% vs. 32.7%, P = 0.04). Cumulative incidences of CNS involvement were significantly greater in the CD56+cohort compared with the CD56-cohort (14.4% vs. 7.5%, P = 0.02). Multivariate analysis revealed CD56 expression to be statistically significant risk factors for CNS involvement.
  
  
  CONCLUSIONS
  CD56 expression should be regarded as an independent risk factor for ALL with CNS involvement in adults.
authors.affiliation: a Department of Laboratory Medicine , The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , Zhejiang Province , China.
authors.forename: Wangqiang
authors.initials: W
authors.lastname: Hu
authors.affiliation: a Department of Laboratory Medicine , The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , Zhejiang Province , China.
authors.forename: Xiaoxia
authors.initials: X
authors.lastname: Wang
authors.affiliation: a Department of Laboratory Medicine , The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , Zhejiang Province , China.
authors.forename: Rongrong
authors.initials: R
authors.lastname: Yang
authors.affiliation: b Department of Hematology , The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , Zhejiang Province , China.
authors.forename: Laixi
authors.initials: L
authors.lastname: Bi
authors.affiliation: a Department of Laboratory Medicine , The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , Zhejiang Province , China.
authors.forename: Yaosheng
authors.initials: Y
authors.lastname: Xie
authors.affiliation: a Department of Laboratory Medicine , The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , Zhejiang Province , China.
authors.forename: Zhuo
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: a Department of Laboratory Medicine , The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , Zhejiang Province , China.
authors.forename: Hong
authors.initials: H
authors.lastname: Lu
authors.affiliation: a Department of Laboratory Medicine , The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , Zhejiang Province , China.
authors.forename: Lianfeng
authors.initials: L
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D014408:Biomarkers, Tumor / Q000096:biosynthesis*; D019002:CD56 Antigen / Q000096:biosynthesis*; D016543:Central Nervous System Neoplasms / Q000378:metabolism* / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000378:metabolism* / Q000473:pathology*; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D019002:CD56 Antigen
keywords: Acute lymphocytic leukemia; CD56; CNS involvement