It is interesting to note the correlation between the molecular characterizations of the patients "clones with the patients" clinical course. Of major clinical and investigative importance are the observations that IgVH gene mutations status and ZAP-70 and CD38 expression have clinical relevance, since cases in whom the majority of the cells express CD38, ZAP-70 and exhibit unmutated IgVH genes have a more aggressive clinical course. Correspondingly, those patients whose clones are in the main CD38 ZAP-70 and express mutated IgVH genes generally fare better and have a good prognosis. In those individual cases that are discordant for the expression of these markers, there is nevertheless generally a direct correlation between the number of unfavorable markers and clinical outcome.
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