Relative value of ZAP-70, CD38, and immunoglobulin mutation status in predicting aggressive disease in chronic lymphocytic leukemia Export

@article{citeulike:3173536, abstract = {Leukemia-cell expression of ZAP-70, CD38, or unmutated immunoglobulin heavy chain variable region genes (U-IGHV) each is associated with aggressive disease in patients with chronic lymphocytic leukemia (CLL). To assess the relative strength of each marker, we defined thresholds for designating a case as positive for CD38 or ZAP-70 in a test cohort of 307 patients and used these data-defined criteria to stratify patients in an independent cohort of 705 patients. Multivariable analysis revealed that ZAP-70 was the strongest risk factor. Knowledge of the IGHV mutation status or CD38 did not improve our ability to predict the time to first treatment except for ZAP-70-negative cases, which could be segregated into 2 groups of intermediate-risk or low-risk disease based on whether they expressed unmutated or mutated IGHV. ZAP-70 maintained its high relative prognostic value for the subset of patients with early-stage, asymptomatic disease, including patients evaluated within 1 year of diagnosis. Although it is premature to recommend therapy based on these risk factors, patients with ZAP-70-positive CLL cells should be monitored closely for disease progression as they have a median time from diagnosis to requiring initial therapy by standard criteria of approximately 3 years. 10.1182/blood-2007-05-092882}, author = {Rassenti, Laura Z. and Jain, Sonia and Keating, Michael J. and Wierda, William G. and Grever, Michael R. and Byrd, John C. and Kay, Neil E. and Brown, Jennifer R. and Gribben, John G. and Neuberg, Donna S. and He, Feng and Greaves, Andrew W. and Rai, Kanti R. and Kipps, Thomas J.}, citeulike-article-id = {3173536}, citeulike-linkout-0 = {http://dx.doi.org/10.1182/blood-2007-05-092882}, citeulike-linkout-1 = {http://bloodjournal.hematologylibrary.org/cgi/content/abstract/112/5/1923}, citeulike-linkout-2 = {http://view.ncbi.nlm.nih.gov/pubmed/18577710}, citeulike-linkout-3 = {http://www.hubmed.org/display.cgi?uids=18577710}, doi = {10.1182/blood-2007-05-092882}, journal = {Blood}, keywords = {cll}, month = {September}, number = {5}, pages = {1923--1930}, posted-at = {2008-08-29 16:45:48}, priority = {2}, title = {Relative value of ZAP-70, CD38, and immunoglobulin mutation status in predicting aggressive disease in chronic lymphocytic leukemia}, url = {http://dx.doi.org/10.1182/blood-2007-05-092882}, volume = {112}, year = {2008} }

TY - JOUR ID - citeulike:3173536 L3 - citeulike-article-id:3173536 N2 - Leukemia-cell expression of ZAP-70, CD38, or unmutated immunoglobulin heavy chain variable region genes (U-IGHV) each is associated with aggressive disease in patients with chronic lymphocytic leukemia (CLL). To assess the relative strength of each marker, we defined thresholds for designating a case as positive for CD38 or ZAP-70 in a test cohort of 307 patients and used these data-defined criteria to stratify patients in an independent cohort of 705 patients. Multivariable analysis revealed that ZAP-70 was the strongest risk factor. Knowledge of the IGHV mutation status or CD38 did not improve our ability to predict the time to first treatment except for ZAP-70-negative cases, which could be segregated into 2 groups of intermediate-risk or low-risk disease based on whether they expressed unmutated or mutated IGHV. ZAP-70 maintained its high relative prognostic value for the subset of patients with early-stage, asymptomatic disease, including patients evaluated within 1 year of diagnosis. Although it is premature to recommend therapy based on these risk factors, patients with ZAP-70-positive CLL cells should be monitored closely for disease progression as they have a median time from diagnosis to requiring initial therapy by standard criteria of approximately 3 years. 10.1182/blood-2007-05-092882 IS - 5 JF - Blood EP - 1930 TI - Relative value of ZAP-70, CD38, and immunoglobulin mutation status in predicting aggressive disease in chronic lymphocytic leukemia VL - 112 SP - 1923 KW - cll AU - Rassenti, Laura AU - Jain, Sonia AU - Keating, Michael AU - Wierda, William AU - Grever, Michael AU - Byrd, John AU - Kay, Neil AU - Brown, Jennifer AU - Gribben, John AU - Neuberg, Donna AU - He, Feng AU - Greaves, Andrew AU - Rai, Kanti AU - Kipps, Thomas PY - 2008/09/01/ UR - http://dx.doi.org/10.1182/blood-2007-05-092882 ER -