CD49 Expression in Chronic Lymphocytic Leukemia B-Cell and Non-Hodgkin Lymphoma

Abstract
Background: B-Chronic lymphocytic leukemia (B-CLL) is a monoclonal disorder which is characterized by the accu-mulation of small mature-appearing B lymphocytes in the blood, bone marrow, and lymphoid tissues. Several reliable prognostic markers were found to be capable of predicting the progression and outcome of the disease from its early stages. these markers including age, sex, lymphocyte mor-phology and number, lymphocyte doubling time (LDT), serum factors and recently immunophenotyping and cytogenetic findings.
CD49d expression consistently identifies a subgroup of CLLwhich is characterized by poor outcome in many recent studies. These observations, recommended its use as a new marker that could be included in the initial prognostic assess-ment of all survival in patients with CLL .
Aim of Study: The aim of this work is to assess the expression pattern of CD49 in patients with (B-CLL) and to evaluate their correlation with different clinical and laboratory data as well as the relation to disease staging and progression. We also aim to find if there is a difference in the expression between patients with B-CLL and B-cell non-Hodgkin lym-phoma (B-NHL).
Material and Methods: This study was done at National Cancer Institute, during the period from January 2018 to March 2018, conducted on 6 B-CLL patients and 5 NHL patients who were evaluated for CD49 to detect their role and specificity in B-CLL. Patients were selected for the study on the basis of standard clinical, hematological and immu-nophenotypic criteria for diagnosis of B-CLL, Their ages ranged from 42–79 years, and 5 healthy, hematologically normal individuals, were chosen as control group. Measuring of CD49 by flow cytometry (Coulter EPICS-XL, USA)
Results: In this study, there was a high significant increase in CD49d expression in CLL cases (p.004) when comparing with control group, A significant correlation was found between positive CD 49d pts. and Rai staging (p 0.015) in which there was an advanced Rai stage (III, IV) among positive CD49d patients in comparison to negative CD49d patients. While for LDH, its level was high significant (p.005) among positive CD49d patients compared to negative CD49d patients.
High significant difference was found between the NHL group and control as regards expression of CD49d (p.0001).
Most NHL (95%) expressed positive CD 49d while only 58% of CLL expressed positive CD 49d which is of statistically significant difference (p<0.05).
Conclusion: The present study confirmed that CD49d expression is a powerful prognostic parameter in patients with CLL. when correlates with RAI stage and LDH level. So CD49d showed association with poor disease outcome in CLL patients. CD49d showed a significant high expression in NHL Thus CD49d is not specific for CLL. But it could be used as a prognostic marker.