Feasibility of an easily applicable method of ZAP-70 measurement in chronic lymphocytic leukemia in the routine flow cytometry setting: A methodological approach

Ann Hematol. 2006 Nov;85(11):795-805. doi: 10.1007/s00277-006-0159-4. Epub 2006 Jul 27.

Abstract

Zeta-associated protein 70 (ZAP-70), determined by flow cytometry, has been advocated a surrogate marker of immunoglobulin (Ig)V(H) unmutated status in B chronic lymphocytic leukemia (CLL). The aim of the current study was to test the applicability of an easy flow cytometry protocol for ZAP-70 measurement in CLL samples. Samples from 61 CLL patients and 44 normal subjects were analyzed using a commercial ZAP-70 monoclonal antibody (1E7.2 clone) conjugated with phycoerythrin (PE) and Alexa 488 fluorochromes. Modifications of the published methods led to the structure of a simplified in-house method of ZAP-70 measurement. A three-color approach was used with CD19, CD3 gating comparing with the isotype control provided by the same manufacturer. The cutoff levels for ZAP-70 positivity were defined from a receiver operator characteristic curve in relation to the IgV(H) mutational status and from the ln normalized mean value +2 SD of normal controls. Using the 20% cutoff value for ZAP-70 positivity in CLL patients defined by the literature, ZAP-PE had a sensitivity of 55% and a specificity of 98% in predicting the IgV(H) mutational status, whereas the corresponding values for ZAP-Alexa were 55% and 84%, respectively. Using the 7% cutoff value for CD38 positivity, the sensitivity was 55%, whereas the specificity was 76%. ZAP-70-positive patients showed a shorter time to disease progression in comparison with ZAP-70-negative patients (p < 0.001). In conclusion, the 100% specific prediction of mutational status is accompanied by reduced sensitivity, thus limiting ZAP-70's applicability either as a single marker or combined with CD38 for the assessment of the mutational status of CLL.

Publication types

  • Evaluation Study

MeSH terms

  • ADP-ribosyl Cyclase 1 / analysis
  • Adult
  • Aged
  • Antigens, CD19
  • Biomarkers / analysis
  • CD3 Complex
  • Case-Control Studies
  • Disease Progression
  • Feasibility Studies
  • Female
  • Flow Cytometry / methods*
  • Flow Cytometry / standards
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / diagnosis*
  • Leukemia, Lymphocytic, Chronic, B-Cell / enzymology
  • Leukemia, Lymphocytic, Chronic, B-Cell / mortality
  • Lymphocytes
  • Male
  • Methods
  • Middle Aged
  • Prognosis
  • ROC Curve
  • Reference Standards
  • Survival Analysis
  • ZAP-70 Protein-Tyrosine Kinase / analysis*

Substances

  • Antigens, CD19
  • Biomarkers
  • CD3 Complex
  • ZAP-70 Protein-Tyrosine Kinase
  • ADP-ribosyl Cyclase 1