Prognostic significance of combined analysis of ZAP-70 and CD38 in chronic lymphocytic leukemia

Giovanni D'Arena, Michela Tarnani, Carlo Rumi, Tiziana Vaisitti, Semra Aydin, Rosaria De Filippi, Francesco Perrone, Antonio Pinto, Patrizia Chiusolo, Silvia Deaglio, Fabio Malavasi, Luca Laurenti

Research output: Contribution to journalArticlepeer-review


The clinical heterogeneity that characterizes chronic lymphocytic leukemia (CLL) poses critical questions concerning the identification of high risk patients. Unmutated IgVH genes, CD38 and ZAP-70 expression have emerged as the most useful tools in identifying aggressive CLL. The simultaneous expression of ZAP-70 and CD38 in 157 patients with CLL has been evaluated. Fifty-seven patients (36%) were positive for ZAP-70 and 46 patients (29%) were positive for CD38. Both molecules were highly correlated and predictive of the clinical course of the disease. According to the simultaneous evaluation of ZAP-70 and CD38, patients were divided into three groups. In 81 patients (52%), there was a negative concordance of both molecules (ZAP-70-/CD38 -); in 27 patients (17%) there was a positive concordance (ZAP-70+/CD38+); in 49 patients (31%) there was a discordant expression (ZAP-70+/CD38- and ZAP-70 -/CD38+). A comparison of the clinical and laboratory data showed in ZAP-70+/CD38+ patients a significantly higher bone marrow and peripheral blood lymphocytosis, lower hemoglobin levels, more advanced clinical stage, and higher number of unmutated IgVH status with respect to the other two groups. Furthermore, ZAP-70+/CD38 + patients displayed a much shorter treatment-free interval (median 12 months vs 42 months in discordant patients and not reached in ZAP-70 -CD38- patients). These results prove that the concomitant evaluation of ZAP-70 and CD38 expression allows the separation of CLL patients in prognostic subgroups and suggest that their simultaneous assessment should become an integral component of the CLL diagnostic grid.

Original languageEnglish
Pages (from-to)787-791
Number of pages5
JournalAmerican Journal of Hematology
Issue number9
Publication statusPublished - Sep 2007

ASJC Scopus subject areas

  • Hematology


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