CD38 Expression and cd19/cd5 co-expression in cll patients with different responses to immunochemotherapy
Authors: T. Perekhrestenko, S. Vydyborets, U. Melnyk
Journal: HemaSphere (2021)

Background: To date, great success has been achieved in the study of B-CLL oncogenetics, according to which the nature of the clinical course of the disease, the effectiveness of using various methods of therapy and predicting pathology is determined, in particular, by the features of pathogenesis, affecting certain structural components of the genome of malignant cells. Despite this, the principles of the genetic determination of B-CLL in the dynamics of the development of pathology are still largely unclear, which complicates the use of expression indicators of CD-marker molecules as diagnostic and prognostic criteria for the disease. Aims: to monitor the expression of CD38 and the co-expression of CD19 and CD5 on lymphocytes of CLL patients with the determination of the relationship between their quantitative changes and the clinical course. Methods: We included 11 CLL patients in the study. The median age was 57.3 years (range 44-68). The expression of CD38 markers and the co-expression of CD19 and CD5 were studied in peripheral blood before initiating therapy and during the treatment. None of the patients had a del17p13, del11q23, del13q14. Patients up to 65 years of age received FCR regimen, after 65 RB or ChlR regimes were administered. Antigen expression monitoring was carried out after the 2nd, 3th, 4th courses of therapy. Expression of CD38, co-expression of CD19/CD5 was determined by flow cytometry in the direct immunofluorescence test using monoclonal antibodies. Results: It was noted that in 7 patients with a positive clinical and hematological effect after the second and subsequent courses of therapy, the expression of the CD38 antigen was either not observed or did not exceed 16%. Five of these patients received FCR regimen, two patients were administered RB. In 5 patients over 65 years of age and who did not receive the FCR regimen, pronounced tumor mass or hyperleukocytosis remained after the second and third courses of therapy. Three of them showed hyperexpression of CD38 + cells, amounting to (69.3 ± 7.1)%. As for the co-expression of CD19 and CD5, it did not differ in 7 patients who responded to therapy and in 5 refractory patients and was (79.5 ± 6.7)% and (80.6 ± 9.4)% after 2 courses, respectively. Similar results were observed in the dynamics of the study. Two patients, who received the RB regimen and were infected with COVID-19, unfortunately died from complications of this viral infection. They did not have any previous cardiovascular pathology or diabetes mellitus. Both patients had overexpression of the CD38 antigen, which was 69% and 74%. Perhaps, besides the negative effect of rituximab and bendamustine on the course of COVID-19, an additional negative role is played by overexpression of the CD38 molecule, which, being a marker of activation, also provides adhesion of lymphocytes to the vascular endothelium, enhances their adhesive-aggregation properties. Summary/Conclusion: Overexpression of the CD 38 antigen is associated with resistance to immunochemotherapy, and also, possibly, has a negative effect on the course of COVID-19 in CLL patients, which requires further research. Coexpression of CD19/CD5 antigens in our study did not change in patients with different responses to immunochemotherapy.