Abstract

BackgroundVLA-4 and CD38 predict a poor clinical outcome in chronic lymphocytic leukemia (CLL). We used CLL samples with discordant VLA-4/CD38 risk to address their individual roles in human bone marrow infiltration (BM), CLL cell homing to murine BM, and in supportive CLL cell-stromal cell interactions.MethodsVLA-4, CD38, and Ki-67 expression was measured in CLL cells from peripheral blood (PB) and bone marrow (BM) aspirates. CLL BM infiltration rates, routinely determined by Pathology, were correlated to VLA-4 and CD38 expression. Short-term homing capacity of CLL cells was evaluated by adoptive transfer experiments. CLL cell viability and adhesion in stromal cell co-culture was determined.ResultsAbout 20% of CLL samples in our cohort displayed discordant VLA-4 and CD38 risk, with either high VLA-4 and low CD38 risk or vice versa. Using particularly such samples, we observed that VLA-4, and not CD38, was responsible for recirculation of CLL cells to murine BM. Human BM infiltration was also significantly higher in patients with high VLA-4 risk but not high CD38 risk. However, both molecules acted as independent prognostic markers. While both VLA-4 and CD38 expression were increased in BM-derived CLL cells, and VLA-4+ and CD38+ subpopulations showed enriched Ki-67 expression, VLA-4 did not contribute to CLL cell protection by stromal cells in vitro.ConclusionsOur data argue for a prominent role of VLA-4 but not CD38 expression in the homing of CLL cells to BM niches and in human BM infiltration,but only a limited role in their protection by stromal cells.

Highlights

  • Chronic lymphocytic leukemia (CLL) is characterized by the accumulation of CD5+ B lymphocytes in the blood, bone marrow (BM) and secondary lymphoid tissues

  • Peripheral blood mononuclear cells (PBMCs) and mononuclear cells of BM aspirates from chronic lymphocytic leukemia (CLL) patients and PBMCs from healthy donors were isolated by Ficoll density gradient centrifugation and freshly used, or viably frozen in FCS plus 10% DMSO for storage in liquid nitrogen

  • Samples with VLA-4 expression on $ 30% of the CLL cells were defined as VLA-4 high-risk samples [2,3]

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Summary

Introduction

Chronic lymphocytic leukemia (CLL) is characterized by the accumulation of CD5+ B lymphocytes in the blood, bone marrow (BM) and secondary lymphoid tissues. CLL is a heterogeneous disease with a highly variable clinical course and a number of molecular prognostic markers have been identified to help determine that course. Among these are VLA-4 and CD38,[1,2,3] two surface molecules that are believed to be mere markers of disease aggressiveness and to play a role in CLL pathogenesis. VLA-4 (a4b1, CD49d/CD29) is the exclusive member of the a4 integrin subfamily expressed by CLL cells and has recently been identified as a negative prognostic marker in this disease[2,3].

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