Discordance of ZAP-70 in patients with chronic lymphocytic leukemia.
B-cell chronic lymphocytic leukemia has a highly variable clinical course with behavior ranging from indolent to aggressive. Identified prognostic markers include IgV(H) mutational status, and CD38 and ZAP-70 expression. In several studies, ZAP-70 expression correlated with IgV(H) mutational status, and predicted disease progression and overall survival. In addition to its prognostic utility, ZAP-70 expression was found to be constant over time, and did not vary between peripheral blood, bone marrow or lymph node specimens in individual patients. In contrast to these reports, we present three CLL patients with discordant ZAP-70 levels. One demonstrated a change in expression with time; the second and third cases had discordant results in blood, lymph node and bone marrow and between blood and bone marrow specimens, respectively, obtained at the same time.
Chaar
B T
BT
Department of Internal Medicine, Saint Louis University School of Medicine, St Louis, MO, USA.
Schergen
A K
AK
Grosso
L E
LE
D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D001853:Bone Marrow / Q000378:metabolism; D005260:Female; D006801:Humans; D007143:Immunoglobulin Heavy Chains; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000145:classification / Q000378:metabolism*; D008198:Lymph Nodes / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D051746:ZAP-70 Protein-Tyrosine Kinase / Q000097:blood / Q000378:metabolism*
D015415:Biomarkers; D007143:Immunoglobulin Heavy Chains; D051746:ZAP-70 Protein-Tyrosine Kinase