The Clinical Utility of LPL and ZAP-70 Expression in Assessment of Prognosis in Patients with B-Cell Chronic Lymphocytic Leukemia
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- Category: Vol. 77, March 2009
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The Clinical Utility of LPL and ZAP-70 Expression in Assessment of Prognosis in Patients with B-Cell Chronic Lymphocytic Leukemia,MOHAMAD R. ALMASRY, HALA MAHMOUD and SAHAR ELWAKIL
Abstract
Background: It was found that B-CLL patients with unmutated immunoglobulin heavy chain variable region (IgVH) have poor prognosis and clinical outcome. The diffi-culty of performing the mutation status of IgHV in the routine diagnostic workup of B-CLL patients, prompts the search for surrogate markers particularly gene expression profile in B-CLL cells.
Objective: To investigate the role of LPL and ZAP-70 expression in assessment of prognosis and survival in a group of B-CLL patients and correlate the results with other prog-nostic variables.
Methods: The study included 47 B-CLL patients who were subjected to clinical staging which was done by Binet and Rai scoring systems. The expression of LPL and ZAP-70 was measured by real-time quantitative PCR (RQ-PCR) and flow-cytometric analysis respectively. The patients were followed over 24 months for proper estimation of treatment free survival (TFS) and disease free survival (DFS).
Results: The results of our study showed positive LPL and ZAP-70 expression in 46.8% and 48.9% of B-CLL patients respectively. There was significant correlation between LPL and ZAP-70 positive expression in our patients (p<0.0001). The positive expression of both genes is associated with advance in clinical staging with significant correlation between LPL & ZAP-70 positive expression and shortening of the TFS and DFS and subsequent classification of most of the LPL+ & ZAP-70+ cases as patients with poor prognosis.
Conclusion: Our study showed that expression of LPL and ZAP-70 has a significant role in determining the prognosis in B-CLL patients, being positive expression of LPL and ZAP-70 is associated with poor prognosis with shortening of TFS and DFS. Also, both genes expression is of great value in selection of B-CLL patients in early clinical stages that are in need to start chemotherapy to avoid progression to aggres-sive forms of the disease.