Abstract
Chronic lymphoid leukemia (CLL) is the most frequent type of adult leukemia. The Rai and Binet staging systems have been well recognized as standards for assessing the treatment requirements and overall survival in CLL patients. However, there is a need to seek newer prognostic markers to identify stable or progressive forms of CLL that will facilitate risk-adapted treatment strategies. Currently a molecular biomarker ZAP-70 has attracted interest as providing prognostic information in CLL patients. To determine the frequency of ZAP-70 positivity in B-CLL patients at disease presentation. From January 2011 to September 2014, 89 patients were diagnosed to have chronic lymphoid leukemia. Complete blood count was done on an automated analyzer (Cell Dyne, Abott Architect, USA), while immunophenotyping was conducted for each patient to establish the diagnosis of the disease. ZAP-70 expression was evaluated by flow cytometry. Data were compiled and analyzed by SPSS version 21. Out of the total of 89 B-CLL patients, 62 (69.7%) were male and 27 (30.3%) were females with a male to female ratio of 2:1. The mean age was 57.5±12.1 years. The frequency of ZAP-70 positivity in our B-CLL patients was found to be 13.5%. ZAP- 70 positivity was significantly correlated with stage III disease and high absolute lymphocytic count (P<0.05). No correlation of ZAP-70 could be established with age and gender (p>0.05). The frequency of ZAP-70 in our patients appears low. It is approximately half that in international data. We would recommend to screen all the newly diagnosed patients with CLL for ZAP-70 protein expression for risk stratification, family counseling and to predict overall survival.
Highlights
Chronic lymphoid l eukemia (CLL) is the commonest adult leukemia in the Western world (Shanafelt, 2009; Kermani et al, 2007; Vroblova et al, 2009)
The rational of our study is to evaluate the prevalence of ZAP-70 positivity in Pakistani B-cell Chronic lymphoid leukemia patients and to determine its correlation with age, gender, stage of disease and hematological parameters
Immunophenotyping was done by flow cytometry or immunohistochemistry to diagnose chronic lymphoid leukemia (CD19, CD20, CD5 and CD23 positivity and FMC7, cyclin D1 and BCL2 to be negative for diagnosis of B-Chronic lymphoid leukemia (CLL))
Summary
Chronic lymphoid l eukemia (CLL) is the commonest adult leukemia in the Western world (Shanafelt, 2009; Kermani et al, 2007; Vroblova et al, 2009). CLL is uncommon in Asian countries, such as Japan and China. It account for as few as 10 percent of all leukemia’s in these regions (Siegel et al, 2014). Chronic lymphoid leukemia (CLL) is the most frequent type of adult leukemia. Objective: To determine the frequency of ZAP-70 positivity in B-CLL patients at disease presentation. The frequency of ZAP-70 positivity in our B-CLL patients was found to be 13.5%. ZAP70 positivity was significantly correlated with stage III disease and high absolute lymphocytic count (P
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