ZAP 70 Featured
Test Code
FLOW ZAP70
Associations
Chronic lymphocytic leukemia(CLL); IgVH mutational status
Methodology
Flow cytometry, multiparameter analysis
CPT Codes
88184 – Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only, first marker
88185 x3 – Each additional marker (multiple)
88187 – Flow cytometry, interpretation, 2 to 8 markers
88185 x3 – Each additional marker (multiple)
88187 – Flow cytometry, interpretation, 2 to 8 markers
Turnaround Time
< 24 hours
Specimen Requirements
- 5.0 mL (min. 2.0 mL) heparin blood preferred, EDTA whole blood accepted
- 3.0 mL (min. 1.0 mL) heparin bone marrow aspirate preferred, EDTA bone marrow accepted
Specimen Stability
Whole blood or bone marrow stable for 48 hours at 18-25°C
Storage & Handling
Whole blood or bone marrow, ship ambient.
Causes for Rejection
Specimen >48 hours old prior to testing; Specimens stored at incorrect temperature; Non-viable specimens; Specimens in inappropriate anticoagulant; Too few cells; Hemolysis; Specimen clotted
Reference Range
See report
Description
ZAP-70 can be measured by flow cytometry and has been reported to correlate with IgVH mutational status and outcomes in cases of classic chronic lymphocytic leukemia patients (CLL). Higher levels of ZAP-70 in neoplastic CLL cells have been reported to be associated with a less favorable clinical course. ZAP-70 evaluation, in conjunction with FISH analysis and clinical parameters, may help identify subsets of patients with an increased risk of progression. ZAP-70 testing is performed on peripheral blood and bone marrow samples.
References
- Shanafelt (2009). B-cell count and Survival: differentiating CLL from monoclonal B-cell lymphocytosis based on clinical outcome. Blood. 113, No.18: 4188-4196.
- Craig and Foon. (2008). Flow Cytometric Immunophenotyping for Hematologic Neoplasms, Blood. 111, No.8: 3941-3967.
- Rawstron et al (2008). Monoclonal B-cell lymphocytosis and CLL. NEJM. 359;6:575-583.
- Special Issue. (2006). Zap-70 and CLL. Cytometry, 70B:4.
- Shanafelt et al. (2004). Prognosis at diagnosis: integrating molecular biologic insights into clinical practice for patients with CLL. Blood. 103(4):1202.
- Crespo et al. (2003). ZAP-70 expression as a surrogate for Immunoglobulin-Variable-Region mutations in chronic lymphocytic leukemia. NEJM. 348(18):1764.