CD49d promotes disease progression in chronic lymphocytic leukemia: new insights from CD49d bimodal expression.

Abstract:

:CD49d is a remarkable prognostic biomarker of chronic lymphocytic leukemia (CLL). The cutoff value for the extensively validated 30% of positive CLL cells is able to separate CLL patients into 2 subgroups with different prognoses, but it does not consider the pattern of CD49d expression. In the present study, we analyzed a cohort of 1630 CLL samples and identified the presence of ∼20% of CLL cases (n = 313) characterized by a bimodal expression of CD49d, that is, concomitant presence of a CD49d+ subpopulation and a CD49d- subpopulation. At variance with the highly stable CD49d expression observed in CLL patients with a homogeneous pattern of CD49d expression, CD49d bimodal CLL showed a higher level of variability in sequential samples, and an increase in the CD49d+ subpopulation over time after therapy. The CD49d+ subpopulation from CD49d bimodal CLL displayed higher levels of proliferation compared with the CD49d- cells; and was more highly represented in the bone marrow compared with peripheral blood (PB), and in PB CLL subsets expressing the CXCR4dim/CD5bright phenotype, known to be enriched in proliferative cells. From a clinical standpoint, CLL patients with CD49d bimodal expression, regardless of whether the CD49d+ subpopulation exceeded the 30% cutoff or not, experienced clinical behavior similar to CD49d+ CLL, both in chemoimmunotherapy (n = 1522) and in ibrutinib (n = 158) settings. Altogether, these results suggest that CD49d can drive disease progression in CLL, and that the pattern of CD49d expression should also be considered to improve the prognostic impact of this biomarker in CLL.

journal_name

Blood

journal_title

Blood

authors

Tissino E,Pozzo F,Benedetti D,Caldana C,Bittolo T,Rossi FM,Bomben R,Nanni P,Chivilò H,Cattarossi I,Zaina E,Norris K,Polesel J,Gentile M,Tripepi G,Moia R,Santinelli E,Innocenti I,Olivieri J,D'Arena G,Laurenti L,Z

doi

10.1182/blood.2019003179

subject

Has Abstract

pub_date

2020-04-09 00:00:00

pages

1244-1254

issue

15

eissn

0006-4971

issn

1528-0020

pii

440985

journal_volume

135

pub_type

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