Clinical significance of soluble cluster of differentiation 14 in B-cell chronic lymphocytic leukemia; relation with ZAP-70, deletion 17p, and trephine biopsy

Background Chronic lymphocytic leukemia (CLL) is a disease that is characterized by the progressive accumulation of morphologically mature but immunologically dysfunctional B-cell lymphocytes in the bone marrow and peripheral blood. CLL follows a highly variable clinical course, from cases with no symptoms that can occasionally resolve on their own to forms that progressively worsen and become life-threatening, so there has always been remarkable interest in determining the prognosis of individual patients. Considerable efforts have been dedicated to identifying reliable markers that can predict outcomes or account for the clinical variability observed in CLL. The soluble form of cluster of differentiation 14 (sCD14) has emerged as a potential prognostic indicator; however, its role in CLL prognosis requires further comprehensive evaluation. This need formed the basis and motivation for conducting our study. Objectives This study was conducted to assess the clinical significance of sCD14 levels in newly diagnosed CLL patients and to explore its correlation with hematological parameters, ZAP-70 expression, B2M, LDH, 17p deletion, and trephine biopsy histopathological findings. Patients and methods The study included 35 newly diagnosed adult B-CLL patients and 35 age-matched and sex-matched healthy controls, all of whom were recruited from the inpatient and outpatient clinics of the Hematology/Oncology Unit at Ain Shams University Hospitals. Results In our study, we found that the mean level of sCD14 was significantly higher in CLL patients than the mean level among controls( P =0.000). We also found that the serum sCD14 concentration was significantly higher in those negative for deletion 17p than those positive for deletion 17p ( P =009). Also, there is significantly higher serum sCD14 concentration in patients who had two lymph node groups and three lymph node groups ( P =0.002). On the other side, we found that there is a higher concentration of sCD14 among patients with Rai stage III, Binet stage B, high-risk MD Anderson Cancer Center prognostic index, and those who have hepatosplenomegaly but with no statistical significance ( P =0.664). Also, we found that there is no significant relationship between sCD14 and trephine biopsy cellularity ( P =0.6), degree of fibrosis ( P =0.4), or pattern of infiltration ( P =0.9). Also there is no significant correlation between serum sCD14 concentration in patients and ZAP-70%, ZAP-70 MFI, ZAP B/T ratio parameters and consequently ZAP positive and negative cases. Also, there was no relation between sCD14 and age, total leukocytic count, hemoglobin, platelet, absolute lymphocytic count, LDH, and B2M. Conclusion The study concluded that serum sCD14 levels at the time of diagnosis in B-CLL patients may serve as an additional prognostic marker for disease progression. Given the significant associations observed between sCD14 levels and clinical parameters such as lymph node involvement, deletion 17p, and the staging score of MD Anderson Cancer Center, it is recommended that sCD14 be measured routinely in B-CLL patients to provide better prognostic information and to aid in the management of the disease while waiting for more specific prognostic results to guide the targeted therapy.