EXPRESSION OF ADHESION MOLECULES IN 113 PATIENTS WITH B-CELL CHRONIC LYMPHOCYTIC-LEUKEMIA - RELATIONSHIP WITH CLINICOPROGNOSTIC FEATURES

The B-cell chronic lymphocytic leukemia (B-CLL) is a heterogeneous dis ease, its clinical and biological behavior possibly being influenced b y surface molecules expressed in B-lymphocytes. These molecules mediat e cell adhesion, mobility and homing. Expression of surface adhesion m olecules of the integrin family (CD11a/CD18 or LFA-1, CD11c/CD18), of the immunoglobulin-related family (CD54), of the selectin family (CD62 L or LAM-1) and the lymphocyte homing receptor (CD44) were analyzed in peripheral cells from 113 B-CLL patients. The association with three prognosis-related parameters (Rai stage, bone marrow pattern and doubl ing time) was determined. The study included only patients with B-CLL lymphocytes of typical morphology, which always expressed CD5 and CD23 . Low expression of integrins, particularly CD18, was associated with advanced disease (Rai stages III-IV) and diffuse bone marrow pattern, even after adjusting for other prognosis-related variables. Expression of CD54 was associated independently with rapid doubling time (less t han 12 months). The association persisted after adjusting for stage an d bone marrow pattern; CD44 was expressed in all patients. No correlat ions were found between expression of CD62L and the prognostic variabl es analyzed. In conclusion, CD54 expression and low CD18 expression ar e both significantly associated with poor prognostic features. (C) 199 7 Elsevier Science Ltd.