THE PROGNOSTIC SIGNIFICANCE OF COMBAIND EXPRESSION OF ZAP-70 AND CD38 IN CHRONIC LYMPHOCYTIC LEUKEMIA.

Our aim was to assess the inter links of the markers CD38 and ZAP-70 based on our materials, the attitude according to the disease stage, and to document which of them had leading meaning for prognosis and treatmend of the disease. In our study we have used flow cytometry for detection CD38 and ZAP-70+ markers expression. (58 patients to assessments their prognostic value in сhronic lymphocytic leukemia (CLL), Correlation to Rai stages and relationships between this markers and outcome of therapy). We divided all patients in two groups based on level of ZAP-70+ cell and CD38+cells,(I group-patients) ZAP-70+ cells <20% CD38+<30% and ZAP-70+ cells >20% and CD38>30%,(II group) becaus our in investigation shows, that ZAP -70+ is very importance independent prognoctic marker as why in ZAP-70+ cases when its number was <20%, patients had favorable prognosis - the big part of them (13(40.6%) didn't need treatment during a long period, but which need the treatment was effective and this patients life expectancy was long (62 mounts). When ZAP-70 cells were>20% (II group n=26) prognosis was unfavorable, patients treatment was not effective and accordingly life expectancy was shorter (39 mounts). Despite CD38 positive or negative cells number. During research where compared were ZAP-70+ and ZAP-70- cases events treatment results and the research was held on the minimal residual disease existence, in ZAP-70+ positive cases treatment the remission obtained was always incomplete, and on the contrary, where the ZAP-70+ was negative - complete. In our study we didn,t reveal the importance of CD38 as a prognostic independent marker and there were not correlation between CD38+ and CD38- cells numbers in CLL prognosis. Because our study data confirm that ZAP-70 marker is more importance marker then CD38 and it has seriously prognostic significance, we think that information about ZAP-70 marker expression. Because our study data confirm that ZAP-70 marker has the advantageous prognostic meaning, we reckon the information on CLL disease debut on ZAP-70 market expression can be used not only for defining the aggressive process of the disease, but also in greater part, to define the refracterity towards the modern chemotherapy regimens.