The Prognostic Implication of CD49d Expression by Flow Cytometry and Trisomy 12 Detection by Fluorescent in situ Hybridization in Chronic Lymphocytic Leukemia
Eman Mosaad Zaki
Department of Clinical Pathology, South Egypt Cancer Institute, Assiut University, Egypt.
Sahar Abd Allah El-Gammal
Department of Clinical Pathology, Faculty of Medicine, Assiut University, Egypt.
Noha Gaber Sayed
Department of Clinical Pathology, South Egypt Cancer Institute, Assiut University, Egypt.
Mayada Fawzy Sediek
Department of Medical Oncology, South Egypt Cancer Institute, Assiut University, Egypt.
Asmaa Ahmed Mohamed *
Department of Clinical Pathology, South Egypt Cancer Institute, Assiut University, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Chronic lymphocytic leukemia (CLL) is the most common chronic lympho‑proliferative disorder. This study done to detect the level of cluster of differentiation (CD)49d in CLL patients by flow cytometry and its correlation with the prognosis (survival) and with (trisomy12) detected by fluorescent in situ hybridization (FISH).
Methods: Clinico - hematological profiles done to fourty CLL patients. CD49d tested by flow cytometry and trisomy12 was detected by FISH.
Results: CLL patients classified according to modified Rai staging system into: low risk 12.5%, intermediate risk 22.5% and high risk 65%. CD49d and trisomy12 positivity were detected in 29 patients (72.5%) and 22 patients (55%), respectively. There was a significant positive correlation between the percentage of trisomy12 and of CD49d cells in CLL patients (P =0.034). And also, between CD49d and CD38 (P =0.034). On the other hand, there was no significant relation between both CD49d and trisomy12 expression and modified Rai staging system.
As regard to overall survival (O.S) and disease free survival (DFS), both CD49d, trisomy12 positive cases were associated with shorter disease free, and overall survivals compared to the negative cases.
Regarding to the relation between the use of combination of fludarabine, cyclophosphamide, and rituximab (FCR) as a standard treatment in CLL and OS and DFS of patients in our study, we found that FCR account for the better outcome associated with its use.
Conclusion: CLL B-cell membrane expression of CD49d as measured by flow cytometry is a powerful prognostic parameter in patients with CLL. Its positive correlation with the trisomy12 and CD38 and the association of both CD49d and trisomy12 with short survival times indicate that they may have roles in the prognosis of CLL.
Keywords: Chronic lymphocytic leukemia, prognosis, CD49d, trisomy12.