Expression of CD56 is a risk factor for acute lymphocytic leukemia with central nervous system involvement in adults

Figures & data

Table 1. Clinical and biological characteristics of ALL according to CD56 expression.

Characteristic	CD56-positive		CD56-negative		P value
	Median (range)	No. (%)	Median (range)	No. (%)
Overall		111 (100)		477 (100)
Age, year	36 (18–70)		37 (18–76)		0.71
18–40		60 (54.1)		264 (55.3)	0.16
41–60		39 (35.1)		171 (35.9)
>60		12 (10.8)		42 (8.8)
Sex
Male		61 (55.0)		220 (46.1)	0.09
Female		50 (45.0)		257 (53.9)
WBC count, × 10^9/L	21.4 (0.7–544.1)		15.3 (0.6–972.4)		0.87
<4		12 (10.8)		86 (18.0)	0.23
4–10		30 (27.0)		100 (21.0)
11–50		33 (29.7)		140 (29.3)
>50		36 (32.5)		151 (31.7)
Platelet count, × 10^9/L	36 (4–282)		35 (6–324)		0.72
<40		57 (51.4)		221 (46.3)	0.60
40–100		30 (27.0)		136 (28.5)
>100		24 (21.6)		120 (25.2)
Hemoglobin, g/dL	84 (39–153)		80 (41–140)		0.27
≤10		69 (62.1)		328 (68.8)	0.18
>10		42 (37.9)		149 (31.2)
Fibrinogen, g/L	3.0 (1.2–5.1)		3.4 (1.1–7.5)		0.09
≤2		15 (13.5)		72 (15.1)	0.67
>2		96 (86.5)		405 (84.9)
Albumin, g/dL	3.8 (2.8–4.7)		3.6 (2.5–4.8)		0.22
≤3.5		37 (33.3)		210 (44.0)	0.04
>3.5		74 (66.7)		267 (56.0)
LDH, U/L	395 (26–6395)			531 (26–12021)	0.08
β2-Microglobulin	2.5 (1.0–6.7)		2.4 (0.8–6.3)		0.70
BMT
Yes		27 (24.3)		104 (21.8)	0.57
No		84 (75.7)		373 (78.2)
Septicemia
Yes		36 (32.4)		160 (33.5)	0.82
No		75 (67.6)		317 (66.5)
Immunophenotype
Pro-B		6 (5.4)		60 (12.6)	0.20
Common-B		63 (56.8)		243 (50.9)
Pre-B		12 (10.8)		72 (15.1)
Mature-B		12 (10.8)		36 (7.6)
Pro-T		6 (5.4)		24 (5.0)
T-cell		12 (10.8)		42 (8.8)
Relapse-risk group
High		90 (81.1)		357 (74.8)	0.17
Standard		21 (18.9)		120 (25.2)
BCR–ABL (n = 317)		56 (100)		261 (100)
Yes		27 (48.2)		93 (35.6)	0.08
No		29 (51.8)		168 (64.4)
MLL/AF4 (n = 421)		54 (100)		367 (100)
Yes		3 (5.6)		18 (4.9)	1.00
No		51 (94.4)		349 (95.1)

Table 2. Immunophenotypic features of ALL patients (n = 588) according to CD56 expression.

Cell-surface antigens	CD56-positive	CD56-negative	P value
	No. (%)	No. (%)
CD13
Positive	34 (30.6)	107 (22.4)	0.07
Negative	77 (69.4)	370 (77.6)
CD33
Positive	52 (46.8)	171 (35.8)	0.03
Negative	59 (53.2)	306 (64.2)
HLA-DR
Positive	75 (67.6)	364 (76.3)	0.06
Negative	36 (32.4)	113 (23.7)
CD117
Positive	13 (11.7)	36 (7.5)	0.15
Negative	98 (88.3)	441 (92.5)
TDT
Positive	6 (5.4)	72 (15.1)	<0.01
Negative	105 (94.6)	405 (84.9)
CD5
Positive	32 (28.8)	80 (16.8)	<0.01
Negative	79 (71.2)	397 (83.2)
CD7
Positive	28 (25.2)	90 (18.9)	0.13
Negative	83 (74.8)	387 (81.1)
CD10
Positive	58 (52.3)	348 (73.0)	<0.01
Negative	53 (47.7)	129 (27.0)
CD19
Positive	84 (75.7)	388 (81.3)	0.18
Negative	27 (24.3)	89 (18.7)
CD15
Positive	30 (27.0)	85 (17.8)	0.03
Negative	81 (73.0)	392 (82.2)
CD20
Positive	40 (36.0)	205 (43.0)	0.18
Negative	71 (64.0)	272 (57.0)
CD22
Positive	33 (29.7)	159 (33.3)	0.47
Negative	78 (70.3)	318 (66.7)

Table 3. Treatment results according to CD56 expression.

Clinical features	CD56-positive	CD56-negative	P value
	No. (%)	No. (%)
Overall	111 (100)	477 (100)
Induction outcome
Complete remission	94 (84.7)	394 (82.6)	0.60
Death	17 (15.3)	83 (17.4)
Event-free survival	25 (22.5)	156 (32.7)	0.04
CNS recurrences	16 (14.4)	36 (7.5)	0.02

Table 4. Statistically significant variables in univariate and multivariate analysis for CNS relapse.

Covariate	Univariate analysis P-value	Multivariate analysis
		95% CI	P value
WBC count (>30 × 10^9/L)	<0.01	1.00–1.01	0.01
LDH (>800 U/L)	0.03		0.11
CD34-positive	0.03		0.23
CD56-positive	0.02	1.36–10.47	0.02

Figure 1. Cumulative incidence of CNS involvement in ALL patients according to CD56 expression.

Figure 2. Overall survival (OS) of CNS involvement in ALL patients according to CD56 expression. (a) Isolated CNS relapse group and CNS combined BM relapse group; (b) CD56-positive group and CD56-negative group.