CD 38

I guess I was the person who recognised that the CD38% can rise over time in CLL, though some people still don't believe it. Although, CD38% is a prognostic factor in CLL it is a rather complicated one. First, people who have a level that stays below 7% never seem to die of CLL. Second, high levels are usually found in patients with unmutated VH genes (though those with unmutated VH genes and low CD38% have a better prognosis). Third, CD38% rises in about 25% of patients for a variety of reasons. Sometimes treatment kills the low CD38 level cells more effectively, so that only those with high levels are left. Sometimes the %age increases as the white count increases. Sometimes the %age increases because the patient has develped another disease. More rarely the CD38% will fall over time.

In your case a rise from 4.9% of 17,160 to 21% of 27,000 may be a sign of disease progression, and may mean that it will eventually need some kind of treatment eventually, but on current evidence this ahould be delayed until symptoms occur. Alternatively you might think about entering a clinical trial exploring the benefits of earlier treatment.

2 April 2005

CD38 was originally describes as a T cell antigen (T10) and it is present  on activated T cells. So when looking at your CD38 result you must be careful to
 look only at the percentage of CD19 cells that are CD38 positive. As long as they are less than 30% you are in the good prognosis group. Note however
that  the results with CD38 are not so exact as those with VH genes or ZAP-70.