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Blood, 15 January 2008, Vol. 111, No. 2, pp. 865-873. Prepublished online as a Blood First Edition Paper on October 24, 2007; DOI 10.1182/blood-2007-05-092486. This Article Full Text Full Text (PDF) Supplemental Figures All Versions of this Article: blood-2007-05-092486v1 111/2/865    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Gattei, V. Articles by Del Poeta, G. Search for Related Content PubMed PubMed Citation Articles by Gattei, V. Articles by Del Poeta, G. Related Collections Neoplasia Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  NEOPLASIA Relevance of CD49d protein expression as overall survival and progressive disease prognosticator in chronic lymphocytic leukemia Valter Gattei1, Pietro Bulian1, Maria Ilaria Del Principe2, Antonella Zucchetto1, Luca Maurillo2, Francesco Buccisano2, Riccardo Bomben1, Michele Dal-Bo1, Fabrizio Luciano2, Francesca M. Rossi1, Massimo Degan1, Sergio Amadori2, and Giovanni Del Poeta2 1 Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano; and 2 Department of Hematology, S. Eugenio Hospital and University of Tor Vergata, Rome, Italy CD49d/4-integrin is variably expressed in chronic lymphocytic leukemia (CLL). We evaluated its relevance as independent prognosticator for overall survival and time to treatment (TTT) in a series of 303 (232 for TTT) CLLs, in comparison with other biologic or clinical prognosticators (CD38, ZAP-70, immunoglobulin variable heavy chain (IGHV) gene status, cytogenetic abnormalities, soluble CD23, β2-microglobulin, Rai staging). Flow cytometric detection of CD49d was stable and reproducible, and the chosen cut-off (30% CLL cells) easily discriminated CD49dlow from CD49dhigh cases. CD49d, whose expression was strongly associated with that of CD38 (P < .001) and ZAP-70 (P < .001), or with IGHV mutations (P < .001), was independent prognosticator for overall survival along with IGHV mutational status (CD49d hazard ratio, HRCD49d = 3.52, P = .02; HRIGHV = 6.53, P < .001) or, if this parameter was omitted, with ZAP-70 (HRCD49d = 3.72, P = .002; HRZAP-70 = 3.32, P = .009). CD49d was also a prognosticator for TTT (HR = 1.74, P = .007) and refined the impact of all the other factors. Notably, a CD49dhigh phenotype, although not changing the outcome of good prognosis (ZAP-70low, mutated IGHV) CLL, was necessary to correctly prognosticate the shorter TTT of ZAP-70high (HR = 3.12; P = .023) or unmutated IGHV (HR = 2.95; P = .002) cases. These findings support the introduction of CD49d detection in routine prognostic assessment of CLL patients, and suggest both pathogenetic and therapeutic implications for CD49d expression in CLL. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: T. D. Shanafelt, C. Hanson, G. W. Dewald, T. E. Witzig, B. LaPlant, J. Abrahamzon, D. F. Jelinek, and N. E. Kay Karyotype Evolution on Fluorescent In Situ Hybridization Analysis Is Associated With Short Survival in Patients With Chronic Lymphocytic Leukemia and Is Related to CD49d Expression J. Clin. Oncol., May 10, 2008; 26(14): e5 - e6. [Full Text] [PDF]

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