doiSerbia

Prognostic significance of new biological markers in chronic lymphocytic leukaemia

Leković Danijela (Klinika za hematologiju, Klinički centar Srbije, Beograd)
Mihaljević Biljana (Klinika za hematologiju, Klinički centar Srbije, Beograd)
Kraguljac-Kurtović Nada (Klinika za hematologiju, Klinički centar Srbije, Beograd)
Peruničić-Jovanović Maja (Klinika za hematologiju, Klinički centar Srbije, Beograd)
Bogdanović Andrija (Klinika za hematologiju, Klinički centar Srbije, Beograd)
Čolović Milica (Klinika za hematologiju, Klinički centar Srbije, Beograd)
Gotić Mirjana (Klinika za hematologiju, Klinički centar Srbije, Beograd)

Introduction. Chronic lymphocytic leukaemia is a disease with heterogeneous clinical course and outcome. Some patients have a progressive course of the disease and require therapy immediately after the diagnosis, while others have a stable form without the need for treatment. Recently, two new biological markers, the expression of CD38 antigen and ZAP-70 have shown independent significance in the prognosis in CLL patients. Objective. The aim of our study was to evaluate the clinical value of CD38 antigen and ZAP-70 expression as predictors of the disease progression and to analyze the correlation of these markers with other B-CLL prognostic markers. Methods. We assessed the expression of CD38 antigens by flow cytometry on peripheral blood samples and the expression of ZAP-70 by immunohistochemistry on formalin-fixed bone marrow (BM) biopsies in 40 newly diagnosed B-CLL patients. Disease progression was defined by the period elapsed from diagnosis to the time to first treatment (TFT). Results. Expression of CD38 antigen correlated positively with ZAP-70 expression (Pearson, r=0.476; p=0.002). Also, correlation analysis results showed that a positive expression of CD38 and ZAP-70 statistically significantly correlated with unfavourable classical prognostic parameters, such as advanced Binet stage C, diffuse BM infiltration, increased lactate-dehydrogenase and beta-2 microglobulin serum levels. Patients with positive expression of CD38 antigen and ZAP-70 had a shorter TFT (log rank, 0.003 vs. 0.049). Conclusion. Both new biological markers were shown to have an exceptional significance in the prediction of prognosis in CLL patients.

Keywords: chronic lymphocytic leukaemia, CD38 antigen, ZAP-70, prognosis