Hus I, Podhorecka M, Bojarska-Junak A, Roliński J, Schmitt M, Sieklucka M, Wasik-Szczepanek E, Dmoszyńska A
Department of Haemato-oncology, Medical University of Lublin, Poland.
Ann Oncol. 2006 Apr;17(4):683-90. doi: 10.1093/annonc/mdj120. Epub 2006 Mar 8.
B-cell chronic lymphocytic leukaemia (B-CLL) is a disease with a highly variable clinical course; some patients never need treatment, while others require intensive treatment early after diagnosis. Recently, some new prognostic factors, such as IgVH mutational status, ZAP-70 and the expression of CD38 in leukaemic cells were introduced to identify attenuated versus progressive types of CLL bearing the potential to facilitate risk-adapted treatment strategies.
To evaluate the clinical value of ZAP-70 and CD38 as predictors of disease progression we assessed the expression of these markers by the flow cytometry method in 156 B-CLL patients.
Both ZAP-70 and CD38 expression were shown to predict the clinical course of the disease, while ZAP-70 expression appeared to be more predictive than CD38 expression and more relevant in defining the cases of B-CLL responsive or refractory to first line chemotherapy. A simultaneous evaluation of ZAP-70 and CD38 expression allowed distinguishing the patients groups with the most favourable prognosis as well as those with the worst. Taken together we recommend assessing both ZAP-70 and CD38 protein expression for the definition of prognostic subgroups in patients with B-CLL.
B细胞慢性淋巴细胞白血病（B-CLL）是一种临床病程高度可变的疾病；一些患者从未需要治疗，而另一些患者在诊断后早期就需要强化治疗。最近，引入了一些新的预后因素，如IgVH突变状态、ZAP-70以及白血病细胞中CD38的表达，以识别具有促进风险适应性治疗策略潜力的CLL衰减型与进展型。
为了评估ZAP-70和CD38作为疾病进展预测指标的临床价值，我们采用流式细胞术方法评估了156例B-CLL患者中这些标志物的表达。
ZAP-70和CD38的表达均显示可预测疾病的临床病程，而ZAP-70的表达似乎比CD38的表达更具预测性，并且在定义对一线化疗有反应或难治的B-CLL病例中更具相关性。同时评估ZAP-70和CD38的表达能够区分预后最良好的患者组和预后最差的患者组。综上所述，我们建议评估ZAP-70和CD38蛋白表达以定义B-CLL患者的预后亚组。
