Introduction
Chronic lymph ocytic leukemia (CLL) is a clonal expansion of small mature lymphocytes accumulating in the blood, bone marrow, and lymphoid organs. The interactions of the CLL microenvironment are known to promote CLL cell survival and proliferation. CD49d, an adhesion molecule belonging to the integrin family mediates cell-to-extracellular matrix and cell-to-cell interactions. CD44 is a glycoprotein and also a major hyaluronan receptor that mediates the response of cells to their cellular microenvironment.
Aim
We aimed to evaluate the value of CD49d and CD44 in CLL patients, and their effect on response to fludarabine, cyclophosphamide, and rituximab therapy, to study the relation of each to the other and its relation to the poor prognostic marker CD38.
Patients and methods
The study included 30 newly diagnosed CLL patients with measurement of the expression of CD49d and CD44 by flow cytometry before and after therapy.
Results
CD49d expression was increased in advanced risk stages according to modified Rai staging, but CD44 had no different expression in the different stages. There is a positive correlation between CD44 with CD49d, CD38 (documented poor prognostic marker) with CD49d, and CD38 with CD44. Lymphadenopathy showed a significant relation with CD49d only. Patients without complete response had a significant higher expression of CD49d, CD38, and CD44 before and after therapy.
Conclusion
The study has shown that the expression of CD49d and CD44 in newly diagnosed CLL patients is related to resistance to the fludarabine, cyclophosphamide, and rituximab therapy and their expression is related to each other and to CD38.