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Prepublished online as a Blood First Edition Paper on May 22, 2003; DOI 10.1182/blood-2003-03-0989.

Submitted March 31, 2003
Accepted May 13, 2003
CD38 is a signaling molecule in B-chronic lymphocytic leukemia cells
Silvia Deaglio, Andrea Capobianco, Luciana Bergui, Jan Durig, Fortunato Morabito, Ulrich Duehrsen, and Fabio Malavasi*
Laboratory of Immunogenetics, Department of Genetics, Biology and Biochemistry, University of Turin Medical School, Turin, Italy; Research Center on Experimental Medicine (CERMS), University of Turin Medical School, Turin, Italy
Department of Medicine and Experimental Oncology, University of Turin Medical School, Turin, Italy
Department of Hematology, University Hospital, Essen, Germany
Bone Marrow Transplant Center, Bianchi, Melacrino, Morelli Hospital, Reggio Calabria, Italy
* Corresponding author; email: fabio.malavasi{at}unito.it.
The prognosis for B-chronic lymphocytic leukemia (B-CLL) patients is generally less favorable for those expressing CD38. Our working hypothesis is that CD38 is not merely a marker in B-CLL, but that it plays a receptorial role with pathogenetic valencies, ruling the proliferation of the malignant clone. CD38 levels were generally low in the patients examined and monoclonal antibody (mAb) ligation was inefficient in signaling. Other cellular models indicated that molecular density and surface organization are critical for the CD38 functionality. IL-2 induced a marked up-modulation and surface rearrangement of CD38 in all the patients studied. Upon reaching a specific expression threshold, CD38 becomes an efficient receptor in purified B-CLL cells. Indeed, mAb ligation is followed by Ca2+ fluxes and by a markedly increased proliferation. The unsuitability of CD38 to perform as a receptor is obviated through close interaction with the BCR complex and CD19. Upon mAb binding, CD38 translocates to the membrane lipid microdomains, as shown by a co-localization with the GM1 ganglioside and with CD81, a raft-resident protein. Lastly, CD38 signaling in IL-2-treated B-CLL cells prolongs survival and induces the appearance of plasmablasts, providing a pathogenetic hypothesis for the occurrence of Richter syndrome.

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