CD38 prognostic role in chronic lymphocytic leukemia patients treated with standard chemotherapy or targeted agents: a monocentric real-life experience

Introduction: Therapeutic strategies for patients affected by Chronic Lymphocytic Leukemia (CLL) have undergone significant changes over the last decade, shifting from chemoimmunotherapy to targeted therapy. Methods: This retrospective, single-center, real-word study aims to identify candidate prognostic markers in 230 consecutive CLL patients treated with standard chemoimmunotherapies or targeted agents from July 2011 to June 2023. Results: Patients receiving targeted therapy were more likely to have mutated IGHV, while those with a CD38+CD49d+ CLL immunophenotype showed an increased risk of refractoriness and disease recurrence, as demonstrated by multivariate analysis. Conversely, CLL patients with a CD38-CD49d- phenotype received great benefits when treated with targeted agents, whereas advanced age was a negative risk factor for patients treated with standard chemotherapy. Conclusions: In conclusion, CD38 expression emerges as a key prognostic marker in CLL, reinforcing the need to integrate clinical, biological, phenotypic, and molecular factors into treatment decision-making and both standard chemotherapy and targeted regimens remain effective in real-life settings.