CD38 expression correlates with adverse biological features and predicts poor clinical outcome in B-cell chronic lymphocytic leukemia

CD38 identifies a surface molecule with multi-functional activity. Its prog nostic importance in B-cell chronic lymphocytic, leukemia (B-CLL) is curren tly under investigation in view of the fact that two different groups have recently indicated that CD38 expression could be an independent prognostic marker in B-CLL. We analyzed the clinico-biological features of 61 immunologically typical ( CD5+CD23+) B-CLL patients stratified according to the CD38 expression. Twen ty-two (36%) patients expressed CD38 in more than 30% of CD19-positive cell s and were considered as CD38-positive, B-CLL. Atypical morphology (p 0.02) , peripheral blood lymphocytosis (p 0.01) and diffuse histopathologic bone marrow pattern (p 0.003) were findings found to be closely associated with CD38 expression. On the other hand, A and B Binet stages (p 0.02) and inter stitial bone marrow involvement (p 0.005) were more represented in the CD38 -negative B-CLL group. Trisomy 12 was detected more frequently in the CD38- positive B-CLL group, while 13q14 deletions mainly occurred in CD38-negativ e group (p 0.005). Finally, median survival of CD38-positive B-CLL patients was 90 months, while it was not reached at 180 months in CD38-negative pat ients. Taken together, our data strongly suggest that the evaluation of CD38 expre ssion may identify two groups patients with B-CLL greatly differing in thei r clinico-biological features.