ZAP70 and CD38 as Prognostic Markers for Chronic Lymphocytic Leukemia in Egyptian Patients

Background: Chronic Lymphocytic Leukemia (CLL) is the most common leukemia in elderly people, characterized by progressive lymphocytosis caused by the clonal accumulation of CD5, CD19 CD23 B cells in peripheral blood, bone marrow and lymphoid organs. The most important prognostic factors in CLL are clinical stage, markers of tumour load (e.g., thymidine kinase (TK), β2-microglobulin (P2MG) and cellular proteins expression (eg. CD3 8 and ZAP70). Aim of Work: To identify prognostic markers (CD3 8 and ZAP-70) in Egyptian CLL patients in order to investigate the impact of their combined expressions on the treatment outcome and quality of life. Material and Methods: Thirty CLL patients and 20 healthy controls were enrolled in the study. Blood samples of patients and controls were analyzed for the expression of surface CD38 and cytoplasmic ZAP-70 by flowcytometry. Results: 18 patients (60%) out of 30 showed high level of ZAP-70 and CD38 above the cut off value, while the remaining (40%) showed lower level of ZAP-70 and CD38. Conclusion: There was a statistical significant difference between stages in the two groups (ZAP-70+/CD38+ and ZAP-70–/CD38–). Positive cases showed higher prevalence of Stages III and IV while negative cases showed higher prevalence of Stage II with p-value ( 0. 00 1 *). As regards survival analysis, there was no statistical significant difference between the two groups, however; positive cases showed higher median and mean survival period than negative cases with p-value (0.504).