Chronic Lymphocytic Leukemia Coverage from Every Angle

Biomarker May Aid in the Stratification of Prognostic Groups for CLL

By: Julia Fiederlein
Posted: Wednesday, July 22, 2020

A recent cross-sectional study published in the Pakistan Journal of Medical Sciences investigated expression of ZAP-70, CD38, and CD49d in a population of patients with chronic lymphocytic leukemia (CLL). Based on the results, Sunia Ghaffar, MBBS, MPhil, of the Army Medical College, Rawalpindi, Pakistan, and colleagues recommended CD49d be added to the immunophenotyping panel for prognostic stratification of such patients.

In brief, previous studies have found that ZAP-70 and CD38 positivity may indicate poor prognosis in CLL. “[CD49d] expression promotes [an] unfavorable progressive disease course and can identify patients with poor disease outcome,” the investigators added. “Assessing the prognosis of CLL at the time of diagnosis is essential…to segregate patients who need urgent treatment because of the presence of adverse prognostic markers from those who can be placed in a watch-and-wait group.”

A total of 51 patients with newly diagnosed CLL completed the study. Venous blood samples were obtained, and a complete blood cell count assessment was performed. The investigators employed flow cytometry to measure the expression of ZAP-70, CD38, and CD49d in each patient sample. Known negative samples were used as controls. Patients were stratified into groups based on their age: group 1 consisted of patients younger than age 60 (n = 13), and group 2 consisted of patients who were 61 years of age or older (n = 38).

CD38 and CD49d positivity was detected in 49.0% and 41.2% of patients, respectively. ZAP-70 expression was not detected in any patient samples. There appeared to be a positive correlation between the expression of CD38 and CD49d (P < .05). In group 1, three patient samples showed CD38 and CD49d expression. From group 2, CD38 and CD49d expression was detected in 18 patient samples. According to the investigators, there was no apparent positive association between age and CD marker expression (P > .05).

Disclosure: The study authors reported no conflicts of interest.

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