Surface CD14 positivity in B‐cell chronic lymphocytic leukaemia is related to clinical outcome

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Abstract
The aberrant expression of the myelomonocytic antigen CD14 was investigated in 128 untreated patients diagnosed with B‐cell chronic lymphocytic leukaemia (B‐CLL). A cut‐off value of 5 × 109/l CD14‐positive cells was chosen for statistical analysis because it showed the best discriminating power among patients with different clinical features. 56 cases had a CD14+ cell count >5 × 109/l. A significant correlation was found between Rai and Binet stages and total tumour mass (TTM) score on one hand, and the absolute CD14+ cell cut‐off, on the other. This relationship was more evident in Rai 0–II and Binet A–B stages, where a CD14+ cell count >5 × 109/l was preferentially distributed among patients with a higher tumoral mass. In univariate analysis the survival probability at 5 and 10 years showed a significant correlation with Rai and Binet stages, TTM score, CD14+ absolute cell count and median age. The median overall survival (OS) was 63 months for patients with a CD14+ cell count >5 × 109/l and 136 months for those with a CD14+ cell count < 5 × 109/l. In the multivariate Cox regression model, Rai stage, age and CD14+ cell count were independent significant factors for the prediction of OS. Finally, when the same analysis was restricted to Rai stages 0–II, CD14+ cell count was the only significant independent parameter influencing OS, with a relative death risk of 3.8. In conclusion, these data reveal that CD14+ represents an important marker for predicting OS in B‐CLL patients and, therefore, we suggest that it should be included in the immunological characterization of B‐CLL.