Expression of adhesion molecules on leukemic b cells from chronic lymphocytic leukemia patients with predominantly splenic manisfestations

Background: The highly tissue-specific trafficking of normal and malignant lymphocytes to particular organs is mediated by adhesion molecules, or "homing receptors." Among our patients with B cell chronic lymphocytic leukemia 15% demonstrate predominantly splenic manifestations and are classified as stage II(S). Objective: To investigate whether expression of cell surface adhesion molecules can distinguish stage II(S) patients from stage 0 or srage 0 and I CLL patients. Methods: Expression of adhesion molecules belonging to different families was studied in CD 19-positive cells isolated from the blood of 42 patients by dual color flow cytometry. The families included: immunoglobulin superfamily (CD54, CD58), integrin family (β1, β2 and β3 chains, CD11a, CD11c CD49d), selectin family (L-selectin), and lymphocyte homing receptor family (CD44). Results: The average percentage of leukemic cells expressing CD11c in the 23 patients with stage II(S) was 25.7 compared with 13.2% in the 14 patients with stage 0 disease (P = 0.047). The average percentage of leukemic cells expressing CD44 in patients with stage II(S) was 90.5 compared with 77.2% in patients with stage 0 (P = 0.007) and 80% in patients with stages 0 and 1 together (n = 19, P = 0.008). Other adhesion molecules tested did not show a statistically significance difference in expression between the different diseases stages. Conclusions: The higher expression of CD44 and CD11c in cells of CLL patients with predominantly splenic manifestations may account for the tendency of their lymphocytes to home to the spleen.