新诊断的慢性淋巴细胞白血病中 CD49d 表达水平低可能与高危特征和无治疗间期缩短有关。
Low CD49d expression in newly diagnosed chronic lymphocytic leukaemia may be associated with high-risk features and reduced treatment-free-intervals.
机构信息
Department of Haematology, Trinity St. James's Cancer Institute, Dublin, Ireland.
John Durkan Leukaemia Laboratories, Trinity Translational Medicine Institute, Trinity St. James's Cancer Institute, Dublin, Ireland.
出版信息
Eur J Haematol. 2022 Nov;109(5):441-446. doi: 10.1111/ejh.13824. Epub 2022 Aug 9.
This study was carried out to assess the prognostic power of low CD49d expression (≥10%) in newly diagnosed CLL patients using a previously described cohort. Eighty-five patients were included. Median age at diagnosis; 70 years (43-88); CD49d was expressed in 33/85 (38.8%); 23/33 (69.7%) at ≥30% referred to as 'HiCD49d' and 10/33 (30.3%) between 10 and 30% with a bimodal pattern on scatterplot analysis referred to as 'LoCD49d'. Eleven patients (12.9%) presented as Binet stage B, of whom 8 (72.7%) were CD49d+ (HiCD49d 7/8; LoCD49d 1/8). Seven of 81 patients (8.6%) were NOTCH1 mutated and all were CD49d+ (p ≤ .01). IgVH analysis was performed on 29 (87.8%) of the CD49d+ cases, of whom 21 (72.4%) were unmutated and 8 (27.6%) were mutated. CD38+/CD49d+ accounted for 11/20 (55%) (CD38+/HiCD49D: 9/11; CD38+/LoCD49D: 2/11). At 42 months, treatment had been initiated in 18/85 (21%) patients, of these 10/33 (30.3%) were CD49d+ versus 8/52 (15.4%) of the CD49d- group. The median treatment free interval for the CD49d+ group was 11 months (HiCD49d; 14.5 months, LoCD49d; 11 months) compared to 21.5 months for the CD49d- group. These findings suggest that the predictive value of CD49d expression is retained at expression levels down to 10%.
本研究旨在使用先前描述的队列评估新诊断的 CLL 患者中低 CD49d 表达（≥10%）的预后能力。共纳入 85 例患者。中位诊断年龄为 70 岁（43-88 岁）；85 例患者中有 33 例（38.8%）表达 CD49d；33 例中有 23 例（69.7%）≥30%，称为“HiCD49d”，10 例（30.3%）在 10-30%之间，散点图分析呈双峰模式，称为“LoCD49d”。11 例（12.9%）患者表现为 Binet 期 B，其中 8 例（72.7%）为 CD49d+（HiCD49d 7/8；LoCD49d 1/8）。7/81 例（8.6%）患者 NOTCH1 突变，均为 CD49d+（p≤.01）。在 CD49d+的 29 例（87.8%）中进行了 IgVH 分析，其中 21 例（72.4%）未突变，8 例（27.6%）突变。CD38+/CD49d+占 20 例（55%）中的 11 例（CD38+/HiCD49D：9/11；CD38+/LoCD49D：2/11）。在 42 个月时，85 例患者中有 18 例（21%）开始治疗，其中 33 例中有 10 例（30.3%）为 CD49d+，而 52 例中的 8 例（15.4%）为 CD49d-组。CD49d+组的无治疗间隔中位数为 11 个月（HiCD49d；14.5 个月，LoCD49d；11 个月），而 CD49d-组为 21.5 个月。这些发现表明，CD49d 表达的预测价值在表达水平低至 10%时仍然保留。
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