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Prepublished online as a Blood First Edition Paper on November 21, 2002; DOI 10.1182/blood-2002-06-1639. This Article Full Text Full Text (PDF) All Versions of this Article: 2002-06-1639v1 101/7/2507    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 Manshouri, T. Articles by Albitar, M. Search for Related Content PubMed PubMed Citation Articles by Manshouri, T. Articles by Albitar, M. Related Collections Immunobiology Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 1 April 2003, Vol. 101, No. 7, pp. 2507-2513 CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Circulating CD20 is detectable in the plasma of patients with chronic lymphocytic leukemia and is of prognostic significance Taghi Manshouri, Kim-anh Do, Xuemei Wang, Francis J. Giles, Susan M. O'Brien, Helen Saffer, Deborah Thomas, Iman Jilani, Hagop M. Kantarjian, Michael J. Keating, and Maher Albitar From the Departments of Hematopathology, Biostatistics, and Leukemia, The University of Texas M. D. Anderson Cancer Center, Houston, TX. CD20 is a 33- to 36-kDa transmembrane phosphoprotein involved in the activation, proliferation, and differentiation of B lymphocytes. The predicted amino acid sequence of the CD20 suggests 4 transmembrane-spanning regions with both N- and C-termini located in the cytoplasm. We demonstrate herein that significant levels of circulating CD20 (cCD20) can be detected in the plasma of patients with chronic lymphocytic leukemia (CLL) and that cCD20 interferes with the binding of rituximab, a humanized anti-CD20 monoclonal antibody, to CLL cells. An enzyme-linked immunosorbent assay (ELISA) was developed to measure circulating cCD20 levels in the plasma. We measured cCD20 levels in the plasma of 180 patients with CLL and correlated these levels with clinical characteristics and outcome. Circulating CD20 levels correlated positively with 2-microglobulin level (p = .006) and percentage of CD38+ cells (p = .03) and negatively with platelet count (p = .004) and hemoglobin level (p = .02). Patients with advanced Rai (III/IV) or Binet (C) stage disease had significantly higher levels of cCD20 than did patients with earlier-stage disease (P = .01 and P = .006, respectively). There was no correlation between cCD20 level and age, lymphocyte count, or white blood cell count. Using a recursive classification method, we found that patients with a cCD20 level more than 1875 nM/L had significantly shorter survival than those with cCD20 1875 nM/L or below (P = .01). The prognostic value of cCD20 was independent of Rai staging or hemoglobin level. Prospective evaluation is indicated to establish whether rituximab dosing should be adjusted according to cCD20 levels. © 2003 by The American Society of Hematology.   CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: W. Ma, H. Kantarjian, B. Bekele, A. C. Donahue, X. Zhang, Z. J. Zhang, S. O'Brien, E. Estey, Z. Estrov, J. Cortes, et al. 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