Prognostic information and biological insights in chronic lymphocytic leukemia by high-resolution immunophenotypic analysis of ZAP70.
The E2997 Phase III trial included preservation of valuable chronic lymphocytic leukemia (CLL) patient specimens and relevant clinical outcome data. Using a novel high-resolution technology on a flow cytometry platform, we assessed 79 E2997 samples for the expression of 27 analytes that reflected the activity of signaling pathways and apoptosis. We found that the expression levels of ZAP70 segregated the samples into two subpopulations with the distribution showing a peak-trough-peak configuration. Although prior assessment of ZAP70 by standard procedures did not reveal any prognostic information, we found by using the trough in the distribution as a cutpoint that ZAP70 expression levels were significantly correlated with both progression-free survival and overall survival. Additionally, the cells expressing high versus low levels of ZAP70 demonstrated distinct molecular organization as indicated by the other analytes assessed. Our analysis demonstrates the value of ZAP70 expression as a prognostic indicator and suggests that the different clinical results may be due to the distinct molecular biology of the ZAP70-low versus the ZAP70-high CLL samples.
Pathfinder Biotech, Cleveland, OH; Department of Pathology, University Hospitals Case Medical Center and Case Western Reserve University, Cleveland, OH.
David
D
Kaplan
Zhuoxin
Z
Sun
Martin S
MS
Tallman
Ian W
IW
Flinn
Wenbin
W
Xiao
Paolo F
PF
Caimi
Nicholas M
NM
Kaye
Hillard M
HM
Lazarus
D002872:Chromosome Deletion; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000235:genetics* / Q000401:mortality*; D025341:Principal Component Analysis; D011379:Prognosis; D051746:ZAP-70 Protein-Tyrosine Kinase / Q000096:biosynthesis* / Q000235:genetics* / Q000378:metabolism
D051746:ZAP-70 Protein-Tyrosine Kinase; C497261:ZAP70 protein, human
ZAP70; chronic lymphocytic leukemia; phospho-ZAP70; prognosis