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ZAP 70

FLOW ZAP

Test Synonym:

IgVH mutational status

CPT Code:

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

Turnaround Time:

<24 hours

Methodology:

Flow cytometry, multiparameter analysis

Specimen Requirements:

  • 5.0ml (min. 2.0ml) heparin blood preferred, EDTA whole blood accepted
  • 3.0ml (min. 1.0ml) heparin bone marrow preferred, EDTA bone marrow accepted
  • 20mm3 bone marrow core biopsy in MPLN RPMI transport media
    • If RPMI media or MPLN RPMI transport media is not available, send in sterile saline

    Causes for Rejection:

    Specimens stored at incorrect temperature; Non-viable specimens; Specimens in inappropriate anticoagulant; Too few cells; Hemolysis; Specimen clotted

    Specimen Stability:

  • Whole blood or bone marrow stable for 48 hours at 18-25°C 
  • Bone marrow biopsy in MPLN RPMI stable for 48 hours at 2-8°C

    • Storage and Handling:

    Whole blood or bone marrow ship ambient

    Bone marrow biopsy ship in a styrofoam container with an ice pack (do not allow the ice pack to directly contact the sample)

    Reference Range:

    2> See report

    Indication:

    Immunophenotype analysis by multi-color flow cytometry is intended to be used as an adjunct to clinical presentation and morphologic, cytochemical, and genetic evaluation to aid in the diagnosis of malignancies of hematolymphoid origin. ZAP-70 expression has been reported to correlate with IgVH mutational status and prognosis in chronic lymphocytic leukemia patients (CLL)1,2. Presence of ZAP-70 on a significant population of CLL cells has been reported to be associated with a less favorable clinical course. ZAP-70 in conjunction with CD38 and FISH analysis may optimize a clinically useful prognostic index when performed in conjunction with current NCI working group guidelines2.

    References:

    1. Crespo et al. (2003). ZAP-70 expression as a surrogate for Immunoglobulin-Variable-Region mutations in chronic lymphocytic leukemia NEJM 348(18):1764
    2. Shanafelt et al. (2004). Prognosis at diagnosis: integrating molecular biologic insights into clinical practice for patients with CLL. Blood 103(4):1202
    3. Special Issue. (2006). Zap-70 and CLL. Cytometry, 70B:4
    4. Craig and Foon. (2008). Flow Cytometric Immunophenotyping for Hematologic Neoplasms, Blood,111, No.8: 3941-3967