CD44 as a diagnostic and prognostic marker in Egyptian patients with non-Hodgkin lymphoma

Abstract

Background CD44 is an adhesion molecule that plays a role in lymphocyte homing; it is a multifunctional cell surface molecule involved in cell proliferation, angiogenesis, presentation of cytokines, chemokines, and growth factors. Patients and methods This study was carried out on 50 newly diagnosed non-Hodgkin lymphoma patients (33 men and 17 women) and 20 healthy controls; the patients were divided into two groups: group I included 20 patients with stage I, II, and III non-Hodgkin lymphoma and group II included 30 patients with stage IV non-Hodgkin lymphoma. They ranged in age from 38 to 75 years; all patients were subjected to a clinical examination, a complete blood count, bone marrow aspiration, and immunophnotyping using monoclonal for CD44 in addition to a routine panel of different chronic lymphoproliferative disorders (CD19, CD5, CD10, CD20, CD22, CD23, SIgM, CD38, CD79b, FMC7, CD103, CD123, κ, and λ light chains). Results CD19, CD20, CD22, CD23, κ/CD19, CD5/CD19, CD10, CD123, and CD103 expression levels showed no statistically significant differences between group I and group II, using the Mann-Whitney U-test, whereas other investigations showed significant differences; these differences were highly significant in terms of gated cell count, CD79b, SIgM, FMC7, λ/CD19, and CD44 expression levels. There was a positive correlation with significant differences between CD44 and FMC7, lymphocytic count, and LDH, a positive correlation with significant differences between CD44 and gated cell count and SIgM, and a highly statistically significant correlation between CD44 and λ/CD19, FMC7, lymphocytic count, and platelet count. Sixty percent of CD44-positive patients in group II had lymph node enlargement compared with only 15% of CD44-positive patients in group I. Conclusion Strong CD44 expression appears to be a powerful prognostic indicator in adult non-Hodgkin's lymphoma, with no difference between male and female patients. It is associated with standard poor prognostic markers such as bone marrow infiltration.