Smudge cell percentage as a surrogate marker for ZAP-70 expression in patients with chronic lymphocytic leukemia
Blood Research 2018³â 53±Ç 3È£ p.218 ~ p.222
(Al-Kahiry Waiel) - University of Aden Faculty of Medicine and Health Sciences Department of Hematology
(Tawfik Hadeel Said) - Pharos University in Alexandria Department of Medical Laboratory Technology
(Sharshira Homam) - University of Alexandria Medical Research Institute Department of Hematology
(Ghanem Amal) - University of Alexandria Medical Research Institute Department of Hematology
(El-Gammal Maha) - University of Alexandria Medical Research Institute Department of Hematology
(Mikhael Irene Lewis) - University of Alexandria Medical Research Institute Department of Hematology
Abstract
Background: This study aimed to evaluate the prognostic value of smudge cell percentage as a surrogate marker for zeta-chain-associated protein kinase 70 (ZAP-70) expression in chronic lymphocytic leukemia (CLL) patients.
Methods: Sixty three newly diagnosed CLL patients were investigated at the Hematology Department of the Medical Research Institute of Alexandria University with complete blood count, lactate dehydrogenase, ¥â2 microglobulin levels, ZAP-70 expression, and estimation of the percentage of smudge cells.
Results: The percentage of smudge cells ranged from 2 to 58% with a mean of 24.03¡¾13.98%. Higher percentages of smudge cells (>30%) were statistically significantly associated with markers of better prognosis (negative ZAP-70, early-stage disease according to the Binet and Rai staging systems, as well as low and intermediate risk CLL prognostic index). The percentage of smudge cells showed significantly negative correlation with the ZAP-70 expression and higher area under the curve for prediction of ZAP-70 positivity with better survival for 36 months in patients with >30% smudge cells.
Conclusion: The percentage of smudge cells at presentation of newly diagnosed CLL patients could be used as a surrogate marker for ZAP-70 expression and an additional prognostic marker for disease progression.
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Smudge cells, CLL, ZAP-70, Surrogate, Prognostic, Survival
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The higher the SC percentage, the lower the ZAP-70 expression, and the better the CLL prognosis.