This article is more than 5 years old. Information may no longer be current.

CD49d offers prognostic value for OS, treatment-free survival in CLL

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

The integrin alpha subunit CD49d appears to be a robust flow cytometry-based predictor of overall and treatment-free survival in patients with chronic lymphocytic leukemia, results of a meta-analysis showed.

Researchers evaluated the value of CD49d as a predictive biomarker in CLL. They utilized a combination of patient data from all previously reported studies with a large, unpublished validation study. The independent patient data of 2,972 patients were evaluated.

The researchers established a training/validation strategy to determine the ideal cutoff of CD49d for predicting CLL survival and progression. Pooled analysis of the 2,972 cases was used to estimate the HR for death and treatment related to CD49d. Through center- and stage-stratified Cox analysis, the researchers adjusted for confounders, and repetitive partitioning was used to rate the value of CD49d over other flow cytometry-based markers, such as CD38 and ZAP-70.

Patients defined as CD49d-positive exhibited at least 30% of neoplastic cells expressing CD49d. Among the CD49d-positive patients, the decrease in OS at 5 years was 7% and 23% at 10 years; treatment-free survival decreased 26% at 5 years and 25% at 10 years.

In univariate analysis, the pooled HR of CD49d for OS was 2.5 and 2.3 for treatment-free survival. A Cox model adjusted for clinical and biologic predictors revealed that this HR persisted and retained its magnitude (HR=2).

In hierarchic trees including all patients, or limited to those with early disease or aged 65 years or younger, CD949d was found to be the strongest flow cytometry-based marker, with very modest additional prognostic data added by CD398 or ZAP-70. Bivariate analysis similarly showed that CD49d was strongly predictive of poorer outcomes, independent of CD38 and ZAP-70.

In an accompanying editorial, Daniel Mertens, PhD, of the University of Ulm German Cancer Research Center, wrote, “It remains to be seen whether the prominent functional role of CD49d in homing of CLL cells will make it a prognostic marker with the advent of biologic agents that target BCR signaling and mobilize CLL cells. CD49d would thus provide a paradigm for the rational development of clinical biomarkers by elucidating their molecular function.”

For more information:

• Bulian P. J Clin Oncol. 2014;doi:10.1200/JCO.2013.50.8515JCO.
• Mertens D. J Clin Oncol. 2014;doi:10.1200/JCO.2013.50.8515.

Disclosure: The researchers report no relevant financial disclosures.