Serum Immunoglobulin Paraprotein in Patients with Chronic Lymphocytic Leukemia

Abstract
Background: Chronic Lymphocytic Leukemia (CLL) is the most common chronic lympho-proliferative disorder. This study was done to explore the frequency of serum Immu-noglobulin (Ig) paraprotein in patients with CLL and its correlation with other prognostic factors as expression of CD38 and zeta-chain-associated protein kinase 70 (ZAP70) on malignant lymphocytes.
Aim of Study: To study the frequency of serum immu-noglobulin paraprotein in patients with CLL and its correlation with other prognostic factors as expression of CD38 and ZAP70 on malignant lymphocytes.
Patients and Methods: Clinico-hematological profiles were done to 30 CLL patients. Serum Protein Electrophoresis (SPE) and Immunofixation Electrophoresis (IFE) were per-formed to measure serum Ig paraprotein. ZAP-70 and CD 38 were tested by flow cytometry.
Results: In this study CLL patients were classified accord-ing to modified Rai staging system into: Low risk 10%, intermediate risk 40% and high risk 50%. Four CLL patients (13.4%) had monoclonal gammopathy (M-band), the type of M-band in the 4 patients was IgG-Kappa. One patient (3.3%) had diffuse band (polyclonal gammopathy). ZAP-70 and CD 38 positivity were detected in 7 patients (23.3%) and 15 patients (50%), respectively. There was significant relation between presence of Ig paraprotein in CLL patients and ZAP 70 expression (p=0.034). On the other hand there was no relation between presence of M-band in CLL patients and CD38 expression nor modified Rai staging system.
Conclusion: Monoclonal gammopathy was found in 13.4% of CLL patients. The detection of Ig paraprotein might be applied for the assessment of prognosis in patients with CLL.