The New England Journal of Medicine
e-mail icon  FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |    Advanced Search
Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe
 
A correction has been published: N Engl J Med 2003;349(5):506.

Original Article
PreviousPrevious
Volume 348:1764-1775 May 1, 2003 Number 18
NextNext

ZAP-70 Expression as a Surrogate for Immunoglobulin-Variable-Region Mutations in Chronic Lymphocytic Leukemia
Marta Crespo, B.S., Francesc Bosch, M.D., Neus Villamor, M.D., Beatriz Bellosillo, Ph.D., Dolors Colomer, Ph.D., María Rozman, M.D., Silvia Marcé, B.S., Armando López-Guillermo, M.D., Elies Campo, M.D., and Emili Montserrat, M.D.

 Sign up for free e-toc
 

This Article
-Full Text
- PDF
-PDA Full Text
-PowerPoint Slide Set

Commentary
-Editorial
 by Rai, K. R.

Tools and Services
-Add to Personal Archive
-Add to Citation Manager
-Notify a Friend
-E-mail When Cited
-E-mail When Letters Appear

More Information
-Related Article
 by Murashige, N.
-PubMed Citation
ABSTRACT

Background The mutational status of immunoglobulin heavy-chain variable-region (IgVH) genes in the leukemic cells of chronic lymphocytic leukemia (CLL) is an important prognostic factor in the disease. We investigated whether the expression of ZAP-70 by CLL cells correlated with the IgVH mutational status, disease progression, and survival.

Methods The expression of ZAP-70 was analyzed in T-cell and B-cell lines and in peripheral-blood samples from 56 patients with CLL with the use of flow cytometry, Western blotting, and immunohistochemistry. The results were correlated with the IgVH mutational status and clinical outcome.

Results ZAP-70 was detected by flow-cytometric analysis in cells of T-cell lineage and in leukemic cells from 32 of 56 patients with CLL. In all patients in whom at least 20 percent of the leukemic cells were positive for ZAP-70, IgVH was unmutated, whereas IgVH mutations were found in 21 of 24 patients in whom less than 20 percent of the leukemic cells were positive for ZAP-70 (P<0.001). Concordant results were obtained when ZAP-70 expression was assessed by immunohistochemistry or Western blotting. The level of ZAP-70 expression did not change over time (median, 37 months) in sequential samples from 30 patients with CLL. Patients with Binet stage A CLL who had at least 20 percent ZAP-70–positive leukemic cells had more rapid progression and poorer survival than those with less than 20 percent ZAP-70–positive cells.

Conclusions Among patients with CLL, expression of ZAP-70, as detected by flow-cytometric analysis, correlated with IgVH mutational status, disease progression, and survival.


Source Information

From the Department of Hematology (M.C., F.B., A.L.-G., E.M.) and the Hematopathology Unit (N.V., B.B., D.C., M.R., S.M., E.C.), Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Barcelona, Spain.

Ms. Crespo and Drs. Bosch and Villamor contributed equally to the article.

Address reprint requests to Dr. Bosch at the Department of Hematology, Hospital Clínic, Villarroel 170, Barcelona 08036, Spain, or at fbosch{at}clinic.ub.es.

Full Text of this Article


This article has been cited by other articles:



HOME  |  SUBSCRIBE  |  SEARCH  |  CURRENT ISSUE  |  PAST ISSUES  |  COLLECTIONS  |  PRIVACY  |  TERMS OF USE  |  HELP  |  beta.nejm.org

Comments and questions? Please contact us.

The New England Journal of Medicine is owned, published, and copyrighted © 2009 Massachusetts Medical Society. All rights reserved.