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Blood, 1 January 2006, Vol. 107, No. 1, pp. 197-204.
Prepublished online as a Blood First Edition Paper on September 13, 2005; DOI 10.1182/blood-2005-04-1755.


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NEOPLASIA

ZAP-70 expression in acute lymphoblastic leukemia: association with the E2A/PBX1 rearrangement and the pre-B stage of differentiation and prognostic implications

Sabina Chiaretti, Anna Guarini, Maria Stefania De Propris, Simona Tavolaro, Stefania Intoppa, Antonella Vitale, Simona Iacobelli, Loredana Elia, Cristina Ariola, Jerome Ritz, and Robin Foà

From the Division of Hematology, Department of Cellular Biotechnologies and Hematology, University "La Sapienza," Rome, Italy; and Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.

We evaluated the expression of 2 members of the Syk family, ZAP-70 and Syk, in acute lymphoblastic leukemia (ALL) samples, using data derived from a series of 33 T-ALL and 95 B-lineage adult ALL patients analyzed by oligonucleotide arrays. Of the B-lineage ALL cases, 37 were BCR/ABL+, 10 were ALL1/AF4+, 5 were E2A/PBX1+, and 43 carried no known molecular abnormality. ZAP-70 was highly expressed in T-ALL. A high ZAP-70 expression was also found in a proportion of B-lineage ALL, the highest levels being associated with the E2A/PBX1+ group and the lowest with ALL1/AF4+ cases (P < .001). A higher ZAP-70 expression was also observed in the pre-B group (P < .001). Remarkably, Syk expression was always preserved, suggesting that ZAP-70 expression is not substitutive of Syk. At the protein level, ZAP-70 was evaluated on 39 newly diagnosed ALL patients (25 adults, 14 children) and was detected in 23 cases (59%). ZAP-70 expression was consistently found in Igµ+ cases. Evaluation of long-term outcome in cases without molecular abnormalities showed that the higher levels of ZAP-70 were coupled to a higher relapse rate. In ALL, ZAP-70 expression is associated with the E2A/PBX1 rearrangement and pre-B stage and may have a prognostic role and be a candidate molecule for targeted therapies.


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