Syndecan-1 (sCD138) levels in chronic lymphocytic leukemia: Clinical and hematological correlations

Abstract

Background Syndecan-1 (sCD138) has recently been suggested to predict the clinical course of early- stage chronic lymphocytic leukemia (CLL), but few studies have been reported. This study assessed the role of syndecan-1 in the prognosis of patients with CLL and its correlation with other prognostic markers. Methods This prospective study was performed in the hematology department of an Indian tertiary care center, over nineteen months (Jun. 2009-Jan. 2011). Forty-nine new patients with CLL presented during this period and were included. Twenty age- and gender-matched healthy patients served as controls, and six patients with multiple myeloma were included as positive controls. Baseline serum syndecan-1 concentrations were measured for all patients at presentation using ELISA (Diaclone, Besancon, France). At baseline, patients were divided into low (N=10), intermediate (N=18) and high (N=21) risk cohorts. Serum syndecan-1 levels in these patient subgroups were compared with clinical and laboratory parameters. Results The median syndecan-1 level in patients with CLL (73.32 ng/mL, range, 28.71-268.0 ng/mL) was marginally higher than that in healthy patients (63.10 ng/mL, range, 55.0- 75.11 ng/mL). At presentation, syndecan-1 levels in patients with CLL correlated strongly with symptomatic disease (cytopenias, P=0.004) and higher clinical stage (Rai stage III and IV, P=0.001) markers and poorly with b2-microglobulin level (P=0.270), diffuse BM infiltration (P=0.882), and surrogate mutation status markers (CD 38, P=0.174 and ZAP-70, P=0.459). Syndecan-1 levels dichotomized by the median value were higher with progressive disease markers, e.g. shorter lymphocyte doubling time (LDT, P=0.015) and increased treatment (P=0.099). Conclusion In CLL, serum syndecan-1 (sCD138) levels at presentation correlate with disease burden, and higher baseline levels may predict early treatment.