Correlation between soluble cytoadhesion molecules (svcam-1 and sicam-1)‎ with prognostic markers of disease activity in chronic b-lymphocytic leukemia (b-cll)‎

Abstract EN

Purpose : to investigate the potential usefulness of sVCAM-1 and sICAM-1 in morphologically and immu-nophenotypically confirmed B-CLL as prognostic markers in newly diagnosed patients and to guide in selecting a treatment protocol.

Patients and Methods : the study included 27 newly diagnosed B-CLL patients, in different stages, according to modified Rai classification.

Fifteen age and sex matched healthy volunteers were included as a control group.

Diagnosis was made in all cases by examination of Leish-man-stained peripheral blood and bone marrow smears and was confirmed by phenotypic analysis that was performed on the “Epics profile II” flow cytometer using fluorescein isothiocyanate and phycoerythrin-labeled monoclonal antibodies.

Serum levels of sVCAM-1 and sICAM-1 were measured by the ELISA technique.

Eighteen out of the 27 patients with elevated sVCAM-1 level were treated with chlorambucil or cyclophosphamide and prednisone.

Follow up of the cases was done by serial estimations of sVCAM-1 levels in both treated and untreated patients at 3 month-intervals for one year.

Results : both sVCAM-1 and sICAM-1 were well correlated with clinical staging, i.e.

B-CLL patients representing high risk stages had significantly higher (p < 0.001) serum levels of sVCAM-1 and sICAM-1 compared with intermediate risk and low risk patients.

However, sVCAM-1 was more superior and closely reflected the tumor burden in B-CLL than sICAM-1 as it was strongly correlated with clinical staging, lymphocyte count and β2-microglobulin level.

In the treated group, during the follow up period, 12 patients showed progressive decline of sVCAM-1 and 10 of them remained alive for the whole time of follow up, whereas the remaining 6 patients showed, more or less, a stationary level of sVCAM-1 and four of them died from disease complications.

In the untreated group, 5 patients who had the highest levels of sVCAM-1 progressed rapidly to more advanced stages of the disease and developed complications.

Conclusion : sVCAM-1 is a more sensitive prognostic marker than sICAM-1 as it significantly correlates with tumor burden and serum markers.

Moreover, sVCAM-1 measurement is easy, reproducible and accurate and can be used as a laboratory tool for deciding a treatment or no treatment policy for patients in early stages of the disease.

This needs to be more confirmed in prospective studies on larger numbers of patients and longer follow-up periods.