Expression of ZAP 70 in Chronic Lymphocytic Leukemia (CLL) and its Correlation with Clinical Stages
DOI:
https://doi.org/10.51985/JBUMDC2023201Keywords:
ZAP-70, Chronic Lymphocytic Leukemia (CLL), Binet Stages, Multiparameter flow cytometry(MFC)Abstract
Objective: To ascertain the levels of ZAP-70 expression within the context of Chronic Lymphocytic Leukemia (CLL) patients and to subsequently analyze the potential correlations between ZAP-70 expression and the clinical staging of the disease.
Study Design & Setting: Cross-sectional, descriptive study. Department of Hematology, Armed Forces Institute of Pathology (AFIP), Rawalpindi from July 2021 to December 2021.
Methodology: We included 73 CLL patients of various ages and both genders. and patients having lymphoproliferative disorders other than CLL were excluded. Sysmex XN-3000 was used to do complete blood counts. Diagnosis of CLL was confirmed immunophenotypically by flow cytometry. Samples were processed by standard methods for ZAP70 analysis. Descriptive statistics were expressed in terms of mean ± standard deviation (SD). A Chi-square test was conducted, with a significance level of p-value =0.05 being considered significant.
Results: Among 73 patients, 24 were females (32.9%) and 49 were males (67.1%). Females had a mean age of 69.00±9.47 years, whereas males had a mean age of 65.73±11.12 years. ZAP-70 expression was positive in 8 (11%) and negative in 65 (89.0%) cases. The expression of ZAP-70 in CLL and its correlation with Binet Stages was significant (p=0.002). ZAP- 70 expression in males and females showed no significant difference (p 0.059). ZAP-70 analysis showed no significant difference in patients with age more than 60 years from = 60 years of age (p= 0.275)
Conclusion: ZAP-70 gene expression should be used in routine laboratory settings and can be correlated with the clinical stages of CLL.
References
Haselager MV, Kater AP, Eldering E. Proliferative signals in
chronic lymphocytic leukemia; what are we missing? Front
Oncol. 2020 Oct 8;10:592205. https://doi.org/10.3389 /fonc.
592205
Parikh SA, Meacham PJ, Zent CS, Evans AG. Multiple B cell
malignancies in patients with chronic lymphocytic leukemia:
Epidemiology, pathology, and clinical implications. Leuk
Lymphoma. 2020 Apr 15;61(5):1037-51.https://doi.org/
1080/10428194.2019.1709830
Abdel-Gader EA, Eltayeb NH, Eltahir TA, Altayeb OA, Fadul
EA, Rahman EM, Merghani TH. ZAP-70 expression in Bchronic lymphocytic leukemia in Sudanese patients. Sudan
J Med Sci. 2018;13(4):230-9. https://doi.org/10.18502
/sjms.v13i4.3593
Muacevic A, Adler J, Shaikh M, Ahmed A, Sohail S, Fahim
A, Nohario S, Pervez S. Flow Cytometric Analysis of ZAP-
Protein Expression for B-Cell Chronic Lymphocytic
Leukemia Prognostication: Usefulness and Limitations. Cureus.
Jan 2;12(11). PMCID: PMC7769768.
Basabaeen AA, Abdelgader EA, BaHashwan OS, Babekir
EA, Abdelateif NM, Bamusa SA, Abdelrahim SO, Altayeb
OA, Fadul EA, Ibrahim IK. Combined analysis of ZAP-70
and CD38 expression in sudanese patients with B-cell chronic
lymphocytic leukemia. BMC Res Notes. 2019 Dec;12(1):1-
https://doi.org/10.1186/s13104-019-4319-8
Liu Y, Wang Y, Yang J, Bi Y, Wang H. ZAP-70 in chronic
lymphocytic leukemia: A meta-analysis. ClinChimActa. 2018
Aug 1;483:82-8.https://doi.org/10.1016/j.cca.2018.04.026
Mansouri L, Wierzbinska JA, Plass C, Rosenquist R. Epigenetic
deregulation in chronic lymphocytic leukemia: clinical and
biological impact. InSeminars in cancer biology 2018 Aug 1
(Vol. 51, pp. 1-11). Academic Press.https://doi.org/10.1016/
j.semcancer.2018.02.001
Vásquez A, Baena A, González LA, Restrepo M, Muñoz CH,
Vanegas-García A, Ortiz-Reyes B, Abdoel N, Rojas M, García
LF, Vásquez G. Altered recruitment of Lyn, Syk and ZAP-70
into lipid rafts of activated B cells in systemic lupus
erythematosus. Cell Signal. 2019 Jun 1;58:9-19.https://doi.org/
1016/ j.cellsig.2019.03.003
Chen J, Sathiaseelan V, Moore A, Tan S, Chilamakuri CS,
Roamio Franklin VN, Shahsavari A, Jakwerth CA, Hake SB,
Warren AJ, Mohorianu I. ZAP-70 constitutively regulates
gene expression and protein synthesis in chronic lymphocytic
leukemia. Blood. 2021 Jul 1;137(26):3629-40.https://doi.org/
1182/blood.2020009960
Azmaiparashvili E, Kuchava V. Statistical Analysis of ZAP-
And CD38 Expression in Chronic B-cell Leukemia Patients.
Actamorphologica et anthropologica.;26:3-4.
Khaliq J, Samad S, Siddique S, Imam M, Shamsi TS.
Frequency of Zap-70 and CD38 in Newly Diagnosed Cases
of B-Cell Chronic Lymphocytic Leukemia. Natl J Health
Sciences. 2019;4(2):52-5.
Strati P, Parikh SA, Chaffee KG, Kay NE, Call TG, Achenbach
SJ, Cerhan JR, Slager SL, Shanafelt TD. Relationship between
co-morbidities at diagnosis, survival and ultimate cause of
death in patients with chronic lymphocytic leukaemia (CLL):
a prospective cohort study. Br J Haematol. 2017 Aug;178(3):
-402.https://doi.org/10.1111/bjh.14785
Greipp PT, Smoley SA, Viswanatha DS, Frederick LS, Rabe
KG, Sharma RG, Slager SL, Van Dyke DL, Shanafelt TD,
Tschumper RC, Zent CS. Patients with chronic lymphocytic
leukaemia and clonal deletion of both 17p13. 1 and 11q22.
have a very poor prognosis. Br J Haematol. 2013 Nov;163(3)
:326-33.https://doi.org/10.1111/bjh.12534
Diehl LF, Karnell LH, Menck HR. The National Cancer Data
Base report on age, gender, treatment, and outcomes of patients
with chronic lymphocytic leukemia. Cancer. 1999 Dec
;86(12):2684-92.https://doi.org/10.1002/(SICI)1097-0142
(19991215)86:12%3C2684::AID-CNCR13% 3E3.0.CO;2-V
Mjali A, Al-Shammari HH, Abbas NT, Azeez ZD, Abbas SK.
Leukemia epidemiology in Karbala province of Iraq. Asian
Pac J Cancer Care. 2019;4(4):135-9.https://doi.org/10.31557
/apjcc.2019.4.4.135-139
Shaikh MS, Ahmed A, Sohail S, Fahim A, Nohario SH, Pervez
S. Flow Cytometric Analysis of ZAP-70 Protein Expression
for B-Cell Chronic Lymphocytic Leukemia Prognostication:
Usefulness and Limitations. Cureus. 2020 Nov 24;12(11)
.10.7759/cureus.11691
Gogia A, Sharma A, Raina V, Kumar L, Gupta R, Kumar R.
Prevalence of ZAP-70 and CD 38 in Indian chronic
lymphocytic leukemia patients. Indian J Cancer. 2013 Oct 1;
(4):333.DOI: 10.4103/0019-509X.123620
Attia HR, Ibrahim MH, El-Aziz A, Shereen H, Abdelrahman
AH, Sobeih ME, Hagag HA, Yassa ME, Osman RA, Rawi
R, El-Dayem A. Evaluation of prognostic variables in chronic
lymphocytic leukemia and association with disease stage.
Mol Clin Oncol. 2021 May 1;14(5):1-9.https://doi.org/10.3892
/mco.2021.2262
Zeeshan R, Irfan SM, Sultan S, Bhimani S. ZAP-70 protein
expression in B-cell Chronic Lymphoid Leukemia: A single
center experience from Pakistan. Asian Pac J Cancer Prev.
;16(4):1587-90. https://doi.org/10.7314/ APJCP.2015.
4.1587
Rossi D, Rasi S, Spina V, Bruscaggin A, Monti S, Ciardullo
C, Deambrogi C, Khiabanian H, Serra R, Bertoni F, Forconi
F. Integrated mutational and cytogenetic analysis identifies
new prognostic subgroups in chronic lymphocytic leukemia.
Blood. 2013 Feb 21;121(8):1403-12.https://doi.org/10.1182
/blood-2012-09-458265
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Zahra Tasleem, Hamid Saeed Malik, Hassan Shaukat, Halima Babar, Kehkashan Hasan, Saima Bashir
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal of Bahria University Medical & Dental College is an open access journal and is licensed under CC BY-NC 4.0. which permits unrestricted non commercial use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/4.0