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Blood, 1 July 2001, Vol. 98, No. 1, pp. 181-186
NEOPLASIA
CD38 expression as an important prognostic factor
in B-cell chronic lymphocytic leukemia
Sherif Ibrahim,
Michael Keating,
Kim-Anh Do,
Susan O'Brien,
Yang O. Huh,
Iman Jilani,
Susan Lerner,
Hagop M. Kantarjian, and
Maher Albitar
From the Departments of Hematopathology, Leukemia, and
Biostatistics; The University of Texas M. D. Anderson Cancer
Center, Houston, TX.
CD38 is a transmembrane glycoprotein expressed on the surface
of leukemic cells in a significant percentage of patients with B-cell
chronic lymphocytic leukemia (B-CLL). A recent study suggested that
CD38 expression has prognostic value in CLL. Peripheral blood samples
from 218 patients with B-CLL were analyzed by flow cytometry for CD38
expression on CD5/19+ leukemic cells. Various patient
characteristics were studied including age, sex, Rai and Binet stages,
splenomegaly, hepatomegaly, hemoglobin (Hgb) level,  -2 microglobulin
(2M) level in the serum, number of nodal sites involved with
disease, and length of survival. The Kaplan-Meier method was used to
construct survival curves, and the log-rank statistic was used to
compare these curves. CD38 was expressed in 20% or more of leukemic
cells in 43% of the patients. Patients with high CD38 expression (20%
or more) had significantly shorter survival times
(P =.00005). Multivariate analyses showed that CD38
expression is an important prognostic factor associated with high
incidence of lymph node involvement (P = .004), lower hemoglobin level (P = .001), hepatomegaly
(P = .05), and high 2M level
(P = .00005). CD38 expression identified a group of patients with aggressive disease that was considered by Rai staging to
be early-stage disease (Rai stages 0-II). Patients with
CD38+ samples have significantly aggressive disease
regardless of their clinical stage. Measurement of CD38 expression by
flow cytometry should become a routine test in the evaluation of
patients with CLL.
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