Haematology Research Group, Haematology Department, Christchurch Hospital, Department of Pathology, University of Otago, Christchurch, New Zealand.
Intern Med J. 2010 Dec;40(12):842-9. doi: 10.1111/j.1445-5994.2009.02135.x.
The aim of this study is to determine whether the analysis of CD38 expression by chronic lymphocytic leukaemia (CLL) cells provides useful additional prognostic information.
Clinical, laboratory, overall survival (OS) and treatment-free survival (TFS) data were collected on 130 CLL patients who had CD38 expression analysed at Canterbury Health Laboratories, New Zealand (NZ) during 1998-2008.
The detection of any level of CD38 expression by CLL cells was associated with a significantly shorter OS and TFS. When analysis was restricted to Binet stage A patients, CD38 expression identified a subset of patients (21%) who, in common with Binet stage B/C patients, had a significantly shorter OS and TFS (P<0.0015), and a TFS at 4 years of <10%. In contrast, CD38-negative Binet stage A patients had an OS that was not significantly different from that of an age/sex-matched NZ population and a 5-year TFS of 77%.
This study indicates that, when combined with clinical staging, the presence of any detectable CD38 expression can be used to further improve the identification of CLL patients with more aggressive disease (i.e. Binet stage B/C or Binet stage A and CD38 positive). This will allow better identification of those patients requiring more intensive monitoring and also allow improved patient counselling regarding prognosis.
本研究旨在确定慢性淋巴细胞白血病（CLL）细胞中 CD38 表达的分析是否提供了有用的附加预后信息。
收集了 130 名 CLL 患者的临床、实验室、总生存（OS）和无治疗生存（TFS）数据，这些患者在 1998 年至 2008 年期间在新西兰坎特伯雷健康实验室（Canterbury Health Laboratories，新西兰）进行了 CD38 表达分析。
CLL 细胞中任何水平的 CD38 表达的检测与 OS 和 TFS 显著缩短相关。当分析仅限于 Binet 分期 A 患者时，CD38 表达确定了一组患者（21%），与 Binet 分期 B/C 患者一样，OS 和 TFS 显著缩短（P<0.0015），4 年 TFS<10%。相比之下，CD38 阴性 Binet 分期 A 患者的 OS 与年龄/性别匹配的新西兰人群无显著差异，5 年 TFS 为 77%。
这项研究表明，当与临床分期相结合时，任何可检测到的 CD38 表达的存在可用于进一步改善具有更具侵袭性疾病（即 Binet 分期 B/C 或 Binet 分期 A 和 CD38 阳性）的 CLL 患者的识别。这将允许更好地识别那些需要更密集监测的患者，并允许改善预后的患者咨询。
