Nowe markery prognostyczne przewlekłej białaczki limfocytowej badane metodą immunofenotypizacji

Abstract

Chronic lymphocytic leukemia (CLL) is a clonal lymphoproliferative disease which is characterized by proliferation and accumulation in blood, bone marrow and other tissues, small B-derived cells accompanied by coexpression of CD5 antigen. Diagnosis of CLL shall be based on standard criteria, but at the same time in determining the treatment strategies some prognostic factors will be helpful. Some of them are widely known and used, but with the progress of research, looking for new prognostic factors is useful for improving the strategy.

Material and Methods

In 43 patients, previously untreated, studies were performed by flow-cytometry to determine the prevalence of antigen CD49d, CD11c, CD54 on CLL cells. To determine their significance as prognostic factors correlation of their expression with the recognized standard prognostic factors, such as Rai stage, expression of CD38 and ZAP-70 as well as the presence of cytogenetic changes were done.

Results

In our studies, a positive correlation between the expression of CD38 and CD49d, and ZAP-70 and CD49d on CLL cells were found. It was shown that among patients with CD11c + up 85.7% there were ZAP-70 positive. In addition, a significantly higher incidence of leukemic cells CD49d+ antigen was present in patients in Rai stage III / IV vs. 0/ II. There were no correlations between the number of cells expressing the antigens CD 11c and CD54 and the degree of advancement of Rai and expression of CD38. We also showed no correlation between the expression of CD54 and the expression of ZAP-70 either. In the group of patients CD38 (−), alternatively CD49d (+) and / or CD11c (+) up to 90.9% there were ZAP-70 (+).

Conclusions

• 1.

  Frequency of the incidence of the expression of CD49d correlates with clinical (Rai stage system) and/or risk factors determined by immunophenotype methods (CD38, ZAP-70).

• 2.

  There is a rationale to continue CD11c antigen estimation as a potential prognostic factor based on our results that 86% of CD11c+ cases presented ZAP-70 positivity.