Chronic lymphocytic leukemia (CLL) cell expression of the cell-surface integrin CD49d is associated with lymphadenopathy, according to a study published in the British Journal of Haematology.1
“CD49d expression is strongly related to the presence of lymphadenopathy at the time of diagnosis as well as the development of lymphadenopathy during the course of these disease,” wrote the authors.
CD49d is involved in cell-cell adhesion and leukocyte trafficking and its expression is associated with more aggressive disease. The purpose of this study as to evaluate the pattern of presentation and clinical course associated with CD49d expression among patients with CLL.
The study analyzed CD49d expression by flow cytometry of 797 patients with newly diagnosed CLL/small lymphocytic leukemia. The mean age was 63, 67% were male, 48% had a Rai score of 0, IGHV mutations were present in 53%, and chromosome 13q was deleted in 44%.
CD49d was expressed in 35% of patients. Lymphadenopathy was more common among patients with CD49d expression (69%) compared with those without CD49d expression (36%; P < .001). Trisomy 12, deletion 11q, and unmutated IGHV were also associated with baseline lymphadenopathy.
Patients with a Rai score 1 and who were CD49d-positive at baseline were significantly more likely to develop lymphadenopathy within 3.2 years compared with those who were CD49d-negative (hazard ratio, 2.44; P < .01).
Increasing Rai score and SLL were also associated with a greater number of CD49d-expressing cells.
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According to the authors, “additional studies are needed to determine the biological underpinnings of this observation and its potential implications for the role of imaging in disease monitoring in newly diagnosed CLL.”
- Strati P, Parikh SA, Chaffee KG, et al. CD49d associates with nodal presentation and subsequent development of lymphadenopathy in patients with chronic lymphocytic leukaemia. Br J Haematol. 2017 Apr 7. doi: 10.1111/bjh.14647 [Epub ahead of print]