CD38 and ZAP-70

[kp58ny]

The CLL cells are positive for both CD38 and ZAP-70 what does this mean

[cllady01 Former Volunteer]

kp58ny, to help us answer your question, please answer these questions:

Are those positive findings for a blood test you have just had or maybe someone you are supporting/taking care of? It helps us to give more precise answers if we know bit more of what you are seeking?

Where do you live (country)---Some CLL blood test specifics are related to treatment protocols, and not all countries have the same protocol.

[kp58ny in reply to cllady01]

It's for myself- results from bone marrow biopsy live in USA Thank you

[cllady01 Former Volunteer in reply to kp58ny]

Basically, to answer your questions: CD38 expressed as positive is looked at in relation to time to treat--but it is not foolproof, maybe added to other factors that your bloodwork shows, it MAY help in a decision of time to treat.

ZAP-70 expression relates to the possibility of your immunoglobulin being mutated or unmutated and helping with a more definitive molecular blood test to determine that status which can have a bearing on treatment chosen for you.

Here is some reading about CLL from PINNED POSTS .

Please know that the title "dummies" fits all of us and esp. at the beginnings of our diagnosis and at time of treatment when we are befuddled and our brains go into overload and the words get jumbled---we become tongue-tied. "Dummies" is a description of us all--CLL is a very complicated and almost not pin-downable (my own feeling about this blood cancer).

healthunlocked.com/cllsuppo...

If you haven't asked your Dr. for copies of all your blood tests--including the diagnostic, and those that are more prognostic: FISH and Molecular testing, please do so, to be able to educate yourself--with help from this membership when you want to know, we have some talented "Explainers" here and all questions are seen as need-to-be answered to the best of our non-medically trained abilities.

[kp58ny]

Thank you

[LeoPa]

Depending from the level of positivity (percentage) this means you are more likely to be unmutated. But it's not a given. Did you have your mutation status checked?

[kp58ny in reply to LeoPa]

The only thing I see in the report is p53 Negative Mutated Tumor Suppressor Gene (PAb1801) but they requested additional test : Additional tests ordered: Cytogenetics and FISH (CLL panel)

[LeoPa in reply to kp58ny]

TP53 negative is a good marker.

[kp58ny in reply to LeoPa]

Thank you

[Newdawn Administrator]

Hi kp58ny,

On this basis of this limited information, it would appear that you have been found to have IGHV unmutated status based on what is a ‘surrogate’ marker for CD 38 & ZAP-70 taken from your flow cytometry test. The definitive test for IGHV mutational status is a separate test usually done alongside but separate to the FISH test. It’s not routinely done in the U.K. until treatment is due.

Patients with less that 30 percent CD38+ B-CLL cells are likely to have mutated IgHV genes while patients with greater than 30 percent+ B-CLL cells are more likely to have unmutated IgHV genes. Being positive is usually indicative of higher than 30%. While this is often the case, there is approximately a 30 percent discordance between assays for CD38 and IgHV mutational status. This essentially means it can sometimes be incorrect. It is a surrogate indicator and usually doesn’t change though this is also subject to dispute in 25% of cases.

The presence of ZAP-70 can be detected by flow-cytometric analysis, and the level of expression is thought to correlate with mutational status.

CLL patients with less than 20 percent ZAP-70 positive B-CLL cells are likely to have mutated immunoglobulin V genes, predictive of a more favorable clinical course, while patients with greater than 20 percent positive B-CLL cells are likely to have unmutated immunoglobulin V genes.

ZAP-70 is an abbreviation for Zeta-chain-associated protein kinase 70. Patients with more than 20% positive B-CLL cells are likely to have unmutated immunoglobulin V genes, predictive of a less favourable clinical course.

It’s generally better therefore to be mutated than unmutated but immense developments in treatments for CLL has impacted positively to reduce the disadvantage especially as chemo is not so frequently used.

Hope this helps but for an authoritative explanation, this video is very informative;

survivornet.com/articles/wh...

Newdawn

[kp58ny in reply to Newdawn]

Thank you so much it was very informative