ABSTRACTBackground. CD69 is expressed in several hemopoietic cells and is an early activation marker in chronic lymphocytic leukemia which is a clinically heterogeneous disease, needing novel prognostic parameters with features of prognostic efficiency and ease of execution. Design and Methods. We investigated CD69 by flow cytometry in a series of 417 patients affected by chronic lymphocytic leukemia in comparison with other biological and clinical prognosticators. Results. CD69 was associated with Rai stages (P=0.00002), beta2-microglobulin (P=0.0005) and soluble CD23 (P<0.0001). CD69 and ZAP-70 (P=0.018) or CD38 (P=0.00015) or immunoglobulin variable heavy chain gene mutations (P=0.0005) were also significantly correlated. Clinically, CD69+ chronic lymphocytic leukemias received chemotherapy more frequently (74%; P<0.0001), presented a shorter duration of response after fludarabine plus rituximab (P=0.010) as well as shorter progression free survival and overall survival (P<0.0001). CD69 demonstrated true additive prognostic properties, since the CD69+ plus ZAP-70+ or CD38+ or immunoglobulin variable heavy chain gene unmutated patients had the worst progression free survival and overall survival (P<0.0001). Noteworthy, low CD69 expression was necessary to correctly prognosticate the longer progression free survival of patients with a low tumor burden of beta2-microglobulin (P=0.002) or of soluble CD23 (P=0.020) or of Rai stages 0-I (P=0.005). CD69 was confirmed to be an independent prognostic factor in multivariate analysis of progression free survival (P=0.017) and overall survival (P=0.039).Conclusions. Our data indicate that CD69 is significantly correlated with poor clinical and biological prognostic factors and is confirmed to be an independent disease prognosticator supporting its introduction in a routine laboratory assessment and, possibly, in a prognostic scoring system for chronic lymphocytic leukemia, after an adequate standardization process.
DEL POETA, G., DEL PRINCIPE, M.i., Zucchetto, A., Luciano, F., Buccisano, F., Rossi, F., et al. (2011). CD69 is independently prognostic in chronic lymphocytic leukemia: acomprehensive clinical and biological profiling study. HAEMATOLOGICA [10.3324/haematol.2011.052829].
CD69 is independently prognostic in chronic lymphocytic leukemia: acomprehensive clinical and biological profiling study
DEL POETA, GIOVANNI;DEL PRINCIPE, MARIA ILARIA;BUCCISANO, FRANCESCO;BRUNO, ANTONIO;DE FABRITIIS, PAOLO;VENDITTI, ADRIANO;AMADORI, SERGIO
2011-10-11
Abstract
ABSTRACTBackground. CD69 is expressed in several hemopoietic cells and is an early activation marker in chronic lymphocytic leukemia which is a clinically heterogeneous disease, needing novel prognostic parameters with features of prognostic efficiency and ease of execution. Design and Methods. We investigated CD69 by flow cytometry in a series of 417 patients affected by chronic lymphocytic leukemia in comparison with other biological and clinical prognosticators. Results. CD69 was associated with Rai stages (P=0.00002), beta2-microglobulin (P=0.0005) and soluble CD23 (P<0.0001). CD69 and ZAP-70 (P=0.018) or CD38 (P=0.00015) or immunoglobulin variable heavy chain gene mutations (P=0.0005) were also significantly correlated. Clinically, CD69+ chronic lymphocytic leukemias received chemotherapy more frequently (74%; P<0.0001), presented a shorter duration of response after fludarabine plus rituximab (P=0.010) as well as shorter progression free survival and overall survival (P<0.0001). CD69 demonstrated true additive prognostic properties, since the CD69+ plus ZAP-70+ or CD38+ or immunoglobulin variable heavy chain gene unmutated patients had the worst progression free survival and overall survival (P<0.0001). Noteworthy, low CD69 expression was necessary to correctly prognosticate the longer progression free survival of patients with a low tumor burden of beta2-microglobulin (P=0.002) or of soluble CD23 (P=0.020) or of Rai stages 0-I (P=0.005). CD69 was confirmed to be an independent prognostic factor in multivariate analysis of progression free survival (P=0.017) and overall survival (P=0.039).Conclusions. Our data indicate that CD69 is significantly correlated with poor clinical and biological prognostic factors and is confirmed to be an independent disease prognosticator supporting its introduction in a routine laboratory assessment and, possibly, in a prognostic scoring system for chronic lymphocytic leukemia, after an adequate standardization process.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
