I’ve now been on watch and wait for 8 years. Looking back at some old test results I read zap 70 negative. Not sure if that’s good. My wbc is now over 80 but immunoglobulins a bit low. I keep hearing I will probably have to have treatment at some point.
Any thoughts please. Thanks.
HazelUK
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Hazel33
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ZAP-70 and CD38 status are surrogate indicators for IgHV mutation status. If you are negative for both, you have about a 70% likelihood of being IgHV mutated, which correlates with a longer time to first treatment and - at least with chemotherapy treatments, a longer remission time. Unfortunately in your case, ZAP-70 is the less reliable of these two indicators, plus both can change over time, whereas IgHV mutation status is quite unlikely to change.
I think your negative Zap 70 is consistent with you being in watch and wait so long, so it likely is a good prognosticator for you.
I actually think Zap 70 is a stronger marker than CD 38. It can be considered a less reliable marker because it’s hard to test and the testing results themselves can be considered not reliable. I went from Zap 70 negative to 50 % Zap 70 weakly positive, whatever that means. While your Zap 70 can change over time, I doubt mine went from negative to 50 %. One of my two Zap 70 tests is likely wrong.
It’s a lab dependent test, so if your Zap 70 test comes from a lab at a major cancer center, the chances of it being valid are better.
As a Neil wrote, IGHV status is the more important marker. It can reliably be tested and, unlike cd38 and Zap 70, it doesn’t change over time. You are probably IGHV mutated with your Zap 70 being negative, and more importantly your Cll moving so slowly.
How our Cll actually does is more important than markers which predict what it is supposed to do.
Thank you for your response. An old test result showed I was Zap70 negative. It may have changed by now. I am going for my check up at the local hospital next week and will bring it up. I’m hoping it is a good prognosticator for me. Fingers crossed 🤞I hope you are doing well on your Cll journey.
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