CLL Coverage from Every Angle

Identifying Prognostic Markers for Early-Stage CLL

By: Joseph Fanelli
Posted: Tuesday, April 6, 2021

The expression of soluble CD23, CD49d, and ZAP-70 genes may be an optimal combination of prognostic markers when evaluating early stages of chronic lymphocytic leukemia (CLL), according to findings presented in Molecular and Clinical Oncology. Additionally, monitoring these markers throughout the disease may help to identify progression to more advanced stages, concluded Hanaa R.M. Attia, MD, of the National Research Centre, Cairo, and colleagues.

“Integrating both serological markers and CD49d expression by flow cytometry may add to the prognostic value of each marker alone and help identify high-risk patients with a higher tumor burden,” the authors added.

In this study, the authors enrolled 81 patients with CLL, with 75 healthy subjects selected for a control group. The expression of CD49d, CD38, and ZAP-70 in CLL cells was analyzed using flow cytometry. The authors used the fluorescence in situ hybridization technique to evaluate TP53 (del17p), ataxia-telangiectasia (del11q), and 13q14 (del13q14) genes as well as the presence of trisomy 12. The serologic markers β-2 microglobulin (B2M) and soluble CD23 were measured by enzyme-linked immunosorbent assay).

The authors found that the CD49d gene was highly expressed in 25.9% of patients, whereas cytogenetic aberrations were seen in 66.6% of patients. After the researchers categorized patients according to the Binet staging system, a significant increase in the expression of soluble CD23, CD49d, and ZAP-70 was found in those in group C, compared with groups A and B.

Patients with CD49d modifications also exhibited significantly higher expressions of CD38 and trisomy 12, as well as lower expression of del13q14. Those same patients who were CD49d-positive with B2M less than 3.5 µg/mL also had a higher total leukocyte account, higher absolute lymphocyte count, higher expression of CD38, and trisomy 12. These patients had lower expression of del13q14.

Disclosure: The authors reported no conflicts of interest.

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