CD38 expression in CLL: A dynamic marker of prognosis

摘要

Membrane CD38 expression has been identified in numerous studies as an adverse prognostic marker in CLL [1-5], but several aspects of result interpretation remain controversial, most notably the definition of a positive result. Different studies have identified different dichotomous cut-off points for labeling expression as positive or negative, most commonly 20% [4] or 30% [3], while others have recommended that levels as low as 7% may be associated with a poorer prognosis [5]. More recently, it has even been suggested that any level of CD38 expression is a prognostic disadvantage [2]. Furthermore, while in the majority of cases the expression levels are relatively stable over time, in as many as one in four patients there may be significant variability of CD38 expression during the course of the disease [3]. In general it has been found, however, that cases which are absolutely CD38-negative at diagnosis never express CD38 over the course of time.