TY - JOUR
T1 - Prognostic significance of combined analysis of ZAP-70 and CD38 in chronic lymphocytic leukemia
AU - D'Arena, Giovanni
AU - Tarnani, Michela
AU - Rumi, Carlo
AU - Vaisitti, Tiziana
AU - Aydin, Semra
AU - De Filippi, Rosaria
AU - Perrone, Francesco
AU - Pinto, Antonio
AU - Chiusolo, Patrizia
AU - Deaglio, Silvia
AU - Malavasi, Fabio
AU - Laurenti, Luca
PY - 2007/9
Y1 - 2007/9
N2 - 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.
AB - 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.
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U2 - 10.1002/ajh.20936
DO - 10.1002/ajh.20936
M3 - Article
C2 - 17534928
AN - SCOPUS:35748939418
VL - 82
SP - 787
EP - 791
JO - American Journal of Hematology
JF - American Journal of Hematology
SN - 0361-8609
IS - 9
ER -