ZAP70 and CD38 as prognostic markers in Egyptian patients with chronic lymphocytic leukemia / Rania Waheed Mohamed Elsharkawy ; Supervised Somaya Eldeeb , Neemat Kassem , Noha Mahana

Thesis (M.Sc.) - Cairo University - Faculty of Science - Department of Zoology

Chronic lymphocytic leukemia (CLL) is a chronic lymphoproliferative malignancy characterized by progressive lymphocytosis caused by the clonal accumulation of CD5, CD19, and CD23 B cells in the peripheral blood, bone marrow and lymphoid organs. It is the most common leukemia in adults in the western world, occurring predominantly in elderly people. The most important prognostic factors in CLL are clinical stage, markers of tumor load (e.g., thymidine kinase (TK) and Ý2 - microglobulin (Ý2M), cellular protein expression (e.g., CD38 and ZAP70), and genetic parameters including immunoglobulin heavy chain variable gene segment (IGHV) mutational status Purpose: To identify the prognostic markers (CD38 and Zap70) in Egyptian CLL patients in order to investigate the correlate of ZAP70 and CD38 single expressions as well as their combined expressions on the treatment outcome and survival of our CLL patients. Thirty CLL patients and 15 age and sex matched healthy controls were enrolled in the study. Blood samples of patients and controls were analyzed for surface monoclonal antibodies CD38 and cytoplasmic monoclonal antibodies ZAP - 70 by flow cytometry. High level of ZAP70 and CD38 (above cut off > 25%) was shown in 18 patients (60%), while lower level was observed in 12 patients (40%). There was a statistically significant difference between staging in the two groups (ZAP70 + / CD38 + and ZAP70 - / CD38⁻), as positive cases showed higher prevalence of stages III and IV while negative cases showed higher prevalence of stage II. As regards survival analysis, there was no statistically significant difference between the two groups, however; positive cases showed lower median and mean survival times than negative cases

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