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ZAP 70 by FLOW

Test Code

FLOW ZAP70

Associations

Chronic lymphocytic leukemia(CLL); IgVH mutational status

Methodology

Flow cytometry, multiparameter analysis

Turnaround Time

1 day

Specimen Requirements

5.0 mL (min. 2.0 mL) heparin blood preferred, EDTA and ACD 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 2-8°C
Storage & Handling

Whole blood or bone marrow, ship ship in a Styrofoam container with a cool pack. (Do not allow cool/refrigerated pack to directly contact samples)

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
  1. Shanafelt (2009). B-cell count and Survival: differentiating CLL from monoclonal B-cell lymphocytosis based on clinical outcome. Blood. 113, No.18: 4188-4196.
  2. Craig and Foon. (2008). Flow Cytometric Immunophenotyping for Hematologic Neoplasms, Blood. 111, No.8: 3941-3967.
  3. Rawstron et al (2008). Monoclonal B-cell lymphocytosis and CLL. NEJM. 359;6:575-583.
  4. Special Issue. (2006). Zap-70 and CLL. Cytometry, 70B:4.
  5. Shanafelt et al. (2004). Prognosis at diagnosis: integrating molecular biologic insights into clinical practice for patients with CLL. Blood. 103(4):1202.
  6. Crespo et al. (2003). ZAP-70 expression as a surrogate for Immunoglobulin-Variable-Region mutations in chronic lymphocytic leukemia. NEJM. 348(18):1764.