CLINICOPROGNOSTIC IMPLICATIONS OF INCREASED LEVELS OF SOLUBLE CD54 INTHE SERUM OF B-CELL CHRONIC LYMPHOCYTIC-LEUKEMIA PATIENTS - RESULTS OF A MULTIVARIATE SURVIVAL ANALYSIS

Background and Objective. Although less specific than sCD23, sCD54 lev els have clinico-prognostic relevance in B-cell chronic lymphocytic le ukemia (CLL). Since serological markers are now emerging as potentiall y important in CLL, we tried to verity whether sCD54 might complement clinical stages. Methods. Serum levels of sCD54 were determined at the time of diagnosis in 115 previously untreated CLL patients. Results w ere correlated with clinicobiological parameters as well as with survi val. Results. Life-expectancy was significantly shorter in patients wi th higher serum levels of sCD54 (p < 0.001); however In a Cox's multiv ariate survival analysis, the only variables which entered the regress ion model at a significant level were bone marrow (BM) histology (p = 0.03) and lymphocyte doubling time (LDT) (p = 0.04). Interestingly, wh en LDT was excluded from analysis the only significant variables were clinical stages (p < 0.05) and sCD54 (p < 0.05). These results suggest that sCD54 and LDT give similar prognostic information. Interpretatio n and Conclusions. In CLL, sCD54 is a reliable prognostic parameter wh ose value is independent of clinical stages. When investigated in rela tion to clinical outcome, serum levels of sCD54 were able to predict p rogression to a more advanced clinical stage. On the basis of these da ta, an integrated clinico-biological classification which separates in termediate risk into two prognostic subgroups is proposed. (C) 1997, F errata Storti Foundation.