The prognostic of CD38 and CD49d flow cytometry markers in chronic lymphocytic leukemia: a retrospective 5-year study.

Abstract

Background: The prognosis of chronic lymphocytic leukemia (CLL) is determined by various prognostic markers. The importance of the immunophenotypic markers CD38 and CD49d on flow cytometry in CLL is well-established internationally. However, there is no data from South Africa on these markers. Objective: This study assessed the frequency of CD38 and CD49d expression in newly diagnosed CLL patients, and the correlation of these markers with other prognostic variables. Methods: A 5-year retrospective analysis was performed on all newly diagnosed CLL patients. The expression of CD38 and CD49d were correlated with haemoglobin concentration, platelet counts and markers by Fluorescence in situ hybridisation (FISH) analysis. Patient charts were obtained from the haematology clinic for 2-year overall survival (OS) analysis, and described using Kaplan-Meier survival curves. Results: Data from 86 newly diagnosed CLL patients were analyzed. Most of the patients, 70.9% (n=61), were between 60-79 years of age. The frequency of CD38 positivity was 29% (n=25), CD49d positivity was 15.1% (n=13), dual positivity for CD38 and CD49d was 15.1% (n=13) and dual negativity was 40.7% (n=35). Of the 37% (n=33) who had CLL FISH studies, seven had 13q deletion, ten had trisomy 12 and two had 11q deletion. CD49d expression correlated with trisomy12 with (p value 0.002). Conclusion: The incidence of CD49d expression in KwaZulu-Natal, was lower than that described in CLL internationally. Although there was some correlation with molecular abnormalities detected by FISH, further prospective studies are warranted to confirmif these immunophenotypic markers can be utilized as surrogate prognostic markers in CLL.