The expression of zeta-associated protein 70 (ZAP-70) in chronic lymphocytic leukemia (CLL) seems to correlate with the mutational status of the immunoglobulin heavy-chain variable-region genes, clinical course and patient prognosis. The aim was to determine the prognostic significance of the immunohistochemical expression of ZAP-70 protein in CLL by means of the long-term follow-up of 108 patients. This study identified 3 patterns of ZAP-70 immunoreactivity: negative (58 patients, 54%), weakly positive (20 patients, 18%) and strongly positive (30 patients, 28%). Overall, ZAP-70 immunoreactivity correlated with an abnormal karyotype ( p= 0.017), a lymphocyte doubling time (LDT) of <6 months ( p= 0.001) and <12 months ( p= 0.01), Rai II - IV and Binet B - C stage ( p= 0.013), the clinical need for chemotherapy ( p < 0.001) and the need for more than 1 chemotherapy line ( p < 0.001). Kaplan-Meier analysis demonstrated that ZAP-70 immunoreactivity closely correlated with a shorter LDT ( p < 0.0001) and time from diagnosis to initial therapy ( p= 0.0001). The same significance was retained when the patients were stratified into the ZAP-70 immunoreactivity groups ( p < 0.0001). This study shows that ZAP-70 immunoreactivity can be a reliable prognostic marker in CLL and proposes a system for evaluating the results. The observations support the inclusion of the immunohistochemical expression of ZAP-70 in clinical trials involving CLL patients
ZAP-70 immunoreactivity is a prognostic marker of disease progression in chronic lymphocytic leukemia / C. Vener, U. Gianelli, A. Cortelezzi, N.S. Fracchiolla, F. Somalvico, F. Savi, M.C. Pasquini, S. Bosari, G. Lambertenghi Deliliers. - In: LEUKEMIA & LYMPHOMA. - ISSN 1042-8194. - 47:2(2006), pp. 245-251.
ZAP-70 immunoreactivity is a prognostic marker of disease progression in chronic lymphocytic leukemia
C. VenerPrimo
;U. GianelliSecondo
;A. Cortelezzi;N.S. Fracchiolla;F. Somalvico;M.C. Pasquini;S. BosariPenultimo
;G. Lambertenghi DeliliersUltimo
2006
Abstract
The expression of zeta-associated protein 70 (ZAP-70) in chronic lymphocytic leukemia (CLL) seems to correlate with the mutational status of the immunoglobulin heavy-chain variable-region genes, clinical course and patient prognosis. The aim was to determine the prognostic significance of the immunohistochemical expression of ZAP-70 protein in CLL by means of the long-term follow-up of 108 patients. This study identified 3 patterns of ZAP-70 immunoreactivity: negative (58 patients, 54%), weakly positive (20 patients, 18%) and strongly positive (30 patients, 28%). Overall, ZAP-70 immunoreactivity correlated with an abnormal karyotype ( p= 0.017), a lymphocyte doubling time (LDT) of <6 months ( p= 0.001) and <12 months ( p= 0.01), Rai II - IV and Binet B - C stage ( p= 0.013), the clinical need for chemotherapy ( p < 0.001) and the need for more than 1 chemotherapy line ( p < 0.001). Kaplan-Meier analysis demonstrated that ZAP-70 immunoreactivity closely correlated with a shorter LDT ( p < 0.0001) and time from diagnosis to initial therapy ( p= 0.0001). The same significance was retained when the patients were stratified into the ZAP-70 immunoreactivity groups ( p < 0.0001). This study shows that ZAP-70 immunoreactivity can be a reliable prognostic marker in CLL and proposes a system for evaluating the results. The observations support the inclusion of the immunohistochemical expression of ZAP-70 in clinical trials involving CLL patientsPubblicazioni consigliate
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