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Prepublished online as a Blood First Edition Paper on October 24, 2002; DOI 10.1182/blood-2002-06-1801. This Article Full Text Full Text (PDF) All Versions of this Article: 2002-06-1801v1 101/4/1262    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Ghia, P. Articles by Caligaris-Cappio, F. Search for Related Content PubMed PubMed Citation Articles by Ghia, P. Articles by Caligaris-Cappio, F. Related Collections Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 15 February 2003, Vol. 101, No. 4, pp. 1262-1269 CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS The pattern of CD38 expression defines a distinct subset of chronic lymphocytic leukemia (CLL) patients at risk of disease progression Paolo Ghia, Giuseppe Guida, Stefania Stella, Daniela Gottardi, Massimo Geuna, Giuliana Strola, Cristina Scielzo, and Federico Caligaris-Cappio From the Department of Oncological Sciences, University of Torino, Torino, Italy; IRCC, Institute for Cancer Research and Treatment, Candiolo (TO) and University Division of Clinical Immunology and Hematology, Ospedale Mauriziano Umberto I, Torino, Italy. Chronic lymphocytic leukemia (CLL) has a variable clinical course. CD38 expression and IgVH gene mutational status are independent predictors of prognosis, but their relationships and the CD38 cutoff level are unknown. Using cytofluorography, we analyzed CD38 in 148 patients, in 108 of whom we were able to evaluate IgVH mutations, make correlations with disease history, and assess cumulative survival. Three different patient groups were identified by the CD38 expression pattern: a group homogeneously CD38, a group homogeneously CD38+, and a group characterized by a bimodal profile, because of the concomitant presence of variable proportions of 2 distinct populations, one CD38+ and one CD38. In CD38 bimodal expression patients the CD38+ subset was significantly more represented in the bone marrow than in the peripheral blood. For IgVH mutations, 11.4% of CD38, 84.6% of CD38+, and 68.0% of CD38 bimodal expression patients had no mutation. CD38 expression, IgVH mutational status, and traditional prognostic factors were concordant. The progression rate was 12.9% for CD38, 75.0% for CD38+, and 63.3% for CD38 bimodal expression patients. Only 25.8% of the CD38 patients but 63.3% of the bimodal and 75.0% of CD38+ patients were treated. The presence of a CD38+ population, albeit small, correlated with the development of autoimmune manifestations. The CD38 group has not yet reached the median survival, which is 183 months in the CD38+ group and 156 months in the CD38 bimodal expression group, regardless of the size of the CD38+ population. The presence of a distinct CD38+ population within the leukemic clone, rather than a numerical cutoff definition, correlates with IgVH gene mutational status and, irrespective of its size, identifies CLL patients who will have progressive disease. © 2003 by The American Society of Hematology.   CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: L. Kujawski, P. Ouillette, H. Erba, C. Saddler, A. 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