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A high expression of <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>49d (&gt;30%) was found in 142\/415 (34%) patients and was associated with progressive disease (advanced clinical stage, high serum lactate dehydrogenase or \u03b2<jats:sub>2<\/jats:sub>\u2010microglobulin levels; all <jats:italic>p\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0\u00b705) and aggressive disease biology (increased <jats:styled-content style=\"fixed-case\">ZAP<\/jats:styled-content>70 or <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>38, unmutated <jats:italic><jats:styled-content style=\"fixed-case\">IGHV<\/jats:styled-content><\/jats:italic>, trisomy 12, mutations of <jats:italic><jats:styled-content style=\"fixed-case\">NOTCH<\/jats:styled-content>1<\/jats:italic> and <jats:italic><jats:styled-content style=\"fixed-case\">SF<\/jats:styled-content>3B1<\/jats:italic>; all <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0\u00b705). A higher <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>49d expression was also associated with a lower blood lymphocyte count and a higher number of lymphoid areas involved by the disease. Patients with high <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>49d expression were treated more frequently (55% vs. 27%; <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0\u00b7001) and earlier (median time to treatment [<jats:styled-content style=\"fixed-case\">TTT<\/jats:styled-content>] 65\u00b74\u00a0months vs. not reached; <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0\u00b7001) than those with low <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>49d expression. However, no significant differences in response rates were observed. In the subgroup of patients with mutated <jats:italic><jats:styled-content style=\"fixed-case\">IGHV<\/jats:styled-content><\/jats:italic>, high <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>49d expression was predictive of a shorter <jats:styled-content style=\"fixed-case\">TTT<\/jats:styled-content> while other markers, such as <jats:styled-content style=\"fixed-case\">ZAP<\/jats:styled-content>70 and <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>38, were not. In conclusion, in this study <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>49d expression correlated with high\u2010risk <jats:styled-content style=\"fixed-case\">CLL<\/jats:styled-content> biomarkers and proved to be useful for separating patients with mutated <jats:italic><jats:styled-content style=\"fixed-case\">IGHV<\/jats:styled-content><\/jats:italic> into two different prognostic groups.<\/jats:p>","DOI":"10.1111\/bjh.13788","type":"journal-article","created":{"date-parts":[[2015,11,12]],"date-time":"2015-11-12T07:20:46Z","timestamp":1447312846000},"page":"48-55","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["<scp>CD<\/scp>49d (<scp>ITGA<\/scp>4) expression is a predictor of time to first treatment in patients with chronic lymphocytic leukaemia and mutated <i><scp>IGHV<\/scp><\/i> status"],"prefix":"10.1111","volume":"172","author":[{"given":"Tycho","family":"Baumann","sequence":"first","affiliation":[{"name":"Department of Haematology Institute of Haematology and Oncology Hospital Cl\u00ednic Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer University of Barcelona Barcelona Spain"},{"name":"Haematopathology Unit Pathology Department Hospital Cl\u00ednic Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer University of Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio","family":"Delgado","sequence":"additional","affiliation":[{"name":"Department of Haematology Institute of Haematology and Oncology Hospital Cl\u00ednic Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer University of Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo","family":"Santacruz","sequence":"additional","affiliation":[{"name":"Department of Haematology Institute of Haematology and Oncology Hospital Cl\u00ednic Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer University of Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandra","family":"Mart\u00ednez\u2010Trillos","sequence":"additional","affiliation":[{"name":"Department of Haematology Institute of Haematology and Oncology Hospital Cl\u00ednic Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer University of Barcelona Barcelona Spain"},{"name":"Haematopathology Unit Pathology Department Hospital Cl\u00ednic Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer University of Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Rozman","sequence":"additional","affiliation":[{"name":"Haematopathology Unit Pathology Department Hospital Cl\u00ednic Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer University of Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Aymerich","sequence":"additional","affiliation":[{"name":"Haematopathology Unit Pathology Department Hospital Cl\u00ednic Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer University of Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"L\u00f3pez","sequence":"additional","affiliation":[{"name":"Haematopathology Unit Pathology Department Hospital Cl\u00ednic Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer University of Barcelona Barcelona Spain"},{"name":"Institute for Human Genetics Christian\u2010Albrechts\u2010University Kiel &amp; 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