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CD38 expression and immunoglobulin variable region mutations are independent prognostic variables in chronic lymphocytic leukemia, but CD38 expression may vary during the course of the disease

CD38 expression and immunoglobulin variable region mutations are independent prognostic variables in chronic lymphocytic leukemia, but CD38 expression may vary during the course of the disease
CD38 expression and immunoglobulin variable region mutations are independent prognostic variables in chronic lymphocytic leukemia, but CD38 expression may vary during the course of the disease
Although the presence or absence of somatic mutations in the immunoglobulin variable region (IgVH) genes in chronic lymphocytic leukemia (B-CLL) identifies subtypes with very different prognoses, the assay is technically complex and unavailable to most laboratories. CD38 expression has been suggested as a surrogate marker for the 2 subtypes. IgVH mutations and CD38 expression in 145 patients with B-CLL with a long follow-up were compared. The 2 assays gave discordant results in 41 patients (28.3%). Multivariate analysis demonstrated that Binet stage, IgVH mutations and CD38 were independent prognostic indicators. Median survival time in patients whose cells had unmutated IgVH genes and expressed CD38 was 8 years; in those with mutated IgVH genes not expressing CD38, it was 26 years. For those with discordant results, median survival time was 15 years. Thus, although CD38 expression does not identify the same 2 subsets as IgVH mutations in CLL, it is an independent risk factor that can be used with IgVH mutations and clinical stage to select patients with B-CLL with the worst prognoses. Using cryopreserved cells taken at intervals during the course of the disease, however, changes of CD38 expression over time were demonstrated in 10 of 41 patients. Causes of the variation of CD38 expression require further study. Additional prospective studies are required for comparing CD38 expression with other prognostic factors and for taking sequential measurements during the course of the disease.
0006-4971
1023-1029
Hamblin, Terry J.
57389613-7900-48fd-b3e6-8ca8fbdceccb
Orchard, Jenny A.
e9a4b04d-7387-4df0-b3fa-15b5a75bd50b
Ibbotson, Rachel E.
8bb6c482-0996-4e84-b625-7c1f199095e2
Davis, Zadie
ea848a46-b564-448f-b77f-840d86b3cbd9
Thomas, Peter W.
170872d9-476f-451f-b32d-c19bd6058de6
Stevenson, Freda K.
ba803747-c0ac-409f-a9c2-b61fde009f8c
Oscier, David G.
c2620a1d-25bb-48f7-9651-f5d023636381
Hamblin, Terry J.
57389613-7900-48fd-b3e6-8ca8fbdceccb
Orchard, Jenny A.
e9a4b04d-7387-4df0-b3fa-15b5a75bd50b
Ibbotson, Rachel E.
8bb6c482-0996-4e84-b625-7c1f199095e2
Davis, Zadie
ea848a46-b564-448f-b77f-840d86b3cbd9
Thomas, Peter W.
170872d9-476f-451f-b32d-c19bd6058de6
Stevenson, Freda K.
ba803747-c0ac-409f-a9c2-b61fde009f8c
Oscier, David G.
c2620a1d-25bb-48f7-9651-f5d023636381

Hamblin, Terry J., Orchard, Jenny A., Ibbotson, Rachel E., Davis, Zadie, Thomas, Peter W., Stevenson, Freda K. and Oscier, David G. (2002) CD38 expression and immunoglobulin variable region mutations are independent prognostic variables in chronic lymphocytic leukemia, but CD38 expression may vary during the course of the disease. Blood, 99 (3), 1023-1029. (doi:10.1182/blood.V99.3.1023).

Record type: Article

Abstract

Although the presence or absence of somatic mutations in the immunoglobulin variable region (IgVH) genes in chronic lymphocytic leukemia (B-CLL) identifies subtypes with very different prognoses, the assay is technically complex and unavailable to most laboratories. CD38 expression has been suggested as a surrogate marker for the 2 subtypes. IgVH mutations and CD38 expression in 145 patients with B-CLL with a long follow-up were compared. The 2 assays gave discordant results in 41 patients (28.3%). Multivariate analysis demonstrated that Binet stage, IgVH mutations and CD38 were independent prognostic indicators. Median survival time in patients whose cells had unmutated IgVH genes and expressed CD38 was 8 years; in those with mutated IgVH genes not expressing CD38, it was 26 years. For those with discordant results, median survival time was 15 years. Thus, although CD38 expression does not identify the same 2 subsets as IgVH mutations in CLL, it is an independent risk factor that can be used with IgVH mutations and clinical stage to select patients with B-CLL with the worst prognoses. Using cryopreserved cells taken at intervals during the course of the disease, however, changes of CD38 expression over time were demonstrated in 10 of 41 patients. Causes of the variation of CD38 expression require further study. Additional prospective studies are required for comparing CD38 expression with other prognostic factors and for taking sequential measurements during the course of the disease.

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Published date: February 2002

Identifiers

Local EPrints ID: 26347
URI: http://eprints.soton.ac.uk/id/eprint/26347
ISSN: 0006-4971
PURE UUID: 689cfce0-25f7-4c29-bdba-955e9fc9a632
ORCID for Freda K. Stevenson: ORCID iD orcid.org/0000-0002-0933-5021

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Date deposited: 20 Apr 2006
Last modified: 17 Dec 2019 01:57

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