Anca Bojan, Bogdan Fetica, Bogdan Pop, Cătălin Vlad and Patriciu Achimaș-Cadariu
Prognostic value of immunohistochemical expression of ZAP-70 and CD38 in chronic lymphocytic leukaemia detected on bone marrow and lymph node biopsies / Valoarea prognostică a expresiei imunohistochimice a ZAP-70 si CD38 în leucemia limfocitară cronică detectată pe biopsii osteomedulare și limfoganglionare
Bogdan Fetica, Ana-Maria Fit, Luminița Blaga, Annamaria Fulop, Bogdan Pop, Delia Dima, Andrei Cucuianu and Ljubomir Petrov
Chronic lymphocytic leukemia (CLL) has a heterogeneous clinical course. Among useful markers in identifiyng patients with poor outcome are unmutated IgVH, ZAP-70 and CD38 expression. Both ZAP-70 and CD38 were shown to be capable of identifying aggressive CLL.
We analysed data from 35 patients diagnosed with CLL based on morphological and immunophenotypical criteria. In all cases peripheral blood immunophenotyping was performed as initial diagnostic test. Immunohistochemical expression of ZAP-70 and CD38 was evaluated on 21 cases of lymph node biopsies and 14 cases of bone marrow biopsies, performed at the time of diagnosis. In addition in-situ hybridization for EBER-1 was evaluated.
The median age of patients was 60 years and we noted a slight male predominance. The immunophenotypic criteria (C23+, CD5+, CD20+, CD10-, CD3-, cyclinD1-) for B-cell CLL were achieved in all 35 patients. We found that CLL cases showing expression of both markers (ZAP-70+CD38+ patients) are characterised by an unfavourable clinical course as compared with cases that did not show expression of markers (ZAP-70-CD38- patients). Our data showed significant differences in terms of overall survival at 5 years between the two groups. We also found statistically significant differences between patients ZAP-70-CD38- and patients with one or both positive markers (ZAP-70+ and/or CD38+).
Prognostic information given by ZAP-70 and CD38 could be used in guiding treatment decisions and they probably should be recommended to all patients with B-CLL in trying to obtain a more clear profile of the disease at the time of diagnosis.
Cosmina Ioana Gavrilut (Tomescu), Cosmina Bondor, Bogdan Fetica, Annamaria Fulop, Laura Urian and Ljubomir Petrov
The study objective was to examine the clinical and hematological significance of receptor CX3CR1 and megakaryocytes in patients with aplastic anemia.
Method. 40 patients diagnosed with aplastic anemia and 10 case-control were included in the study. Were analyzed bone-marrow biopsies regarding cellularity, the presence of megakaryocytes and immunohistochemical expression of CX3CR1, CD4, CD8, CD45RO. We divided patients according to CX3CR1 intensity and the presence of megakaryocytes in 4 groups, which were analyzed comparatively. We realized the second division of patients in 4 groups, depending on the CX3CR1 intensity and cellularity of bone-marrow biopsy.
Results. Statistically significant differences between the case group and the control group were observed in terms of the percentage of CD8, CD45RO positive cells and positivity for CX3CR1. In the lot of patients with aplastic anemia, we found statistically significant differences between groups with megakaryocytes present and absent, in terms of the number of lymphocytes, platelets, hemoglobin, ESR at 1 hour, ESR at 2 hours, bone marrow cellularity.
Conclusions. CX3CR1 could be involved in the pathogenesis of aplastic anemia, influencing bone marrow cellularity. Megakaryocytes influence more hematological parameters, so we suggest using thrombopoietin receptor analogues as 1st line treatment along with the immunosuppressive treatment.