Abstract

This study was carried out on 41 newly diagnosed chronic lymphocytic leukemia (CLL) patients for investigation of the diagnostic value of CD49d and its correlation with disease outcome in CLL patients. CD49d expression on CLL cells in peripheral blood samples was estimated by flow cytometry analysis. Patients with ≥ 31.5% of neoplastic cells expressing CD49d were considered high CD49d cases. The cases with high CD49d expression were significantly associated with progression to a more advanced stage while lymphocytic doubling (LD) and mortality were not significantly associated with high CD49d expression. Lymphocytic doubling time (LDT) was significantly shorter in high CD49d versus low CD49d of CLL patients. Additionally, high CD49d group showed significantly shorter progression free survival (PFS) when compared to low CD49d group of CLL patients. However, overall survival (OS) did not differ significantly between both high CD49d and low CD49d of CLL patients. Multivariate analysis revealed that CD49d is an independent prognostic factor for predicting lymphocytic doubling time. Moreover, the advanced Rai stage and high CD49d are independent prognostic factors for shorter progression free survival. Overall, CD49d is selected as the most important flow cytometry-based prognostic biomarker regardless of other prognosticators such as CD38 and ZAP-70. Consistently, bivariate analysis revealed that CD49d identified CLL patients with poorer outcome independent of CD38 and ZAP-70. Overall, CD49d acts as an independent bad prognostic marker for B-CLL patients at different stages and a predictor of overall survival.

Keywords: Chronic lymphocytic leukemia; CD49d; B lymphocytes; Malignancies