Relative value of ZAP-70, CD38, and immunoglobulin mutation status in predicting aggressive disease in chronic lymphocytic leukemia

摘要: Leukemia-cell expression of ZAP-70, CD38, or unmutated immunoglobulin heavy chain variable region genes (U-IGHV) each is associated with aggressive disease in patients chronic lymphocytic leukemia (CLL). To assess the relative strength marker, we defined thresholds for designating a case as positive CD38 ZAP-70 test cohort 307 and used these data-defined criteria to stratify an independent 705 patients. Multivariable analysis revealed that was strongest risk factor. Knowledge IGHV mutation status did not improve our ability predict time first treatment except ZAP-70–negative cases, which could be segregated into 2 groups intermediate-risk low-risk based on whether they expressed mutated IGHV. maintained its high prognostic value subset early-stage, asymptomatic disease, including evaluated within 1 year diagnosis. Although it premature recommend therapy factors, ZAP-70–positive CLL cells should monitored closely progression have median from diagnosis requiring initial by standard approximately 3 years.