Molecular and clinical features of the CLL cohort. (A) Relation between CD38 and ZAP-70 in 56 patients with CLL, measured with cut-off values of 20% and 10%, respectively (dotted lines). A strong association between both predictive markers was observed in most (74%; n = 41) patients (Fisher exact test; P < .001). Discordant results were detected in 26% (n = 15) of patients. (B) IgV mutational status in CD38⁺/ZAP-70⁺ (n = 21) and CD38⁻/ZAP-70⁻ (n = 20) patients with CLL, with a cut-off value of 2% (dotted line). CD38⁻/ZAP-70⁻ patients were characterized by heavily mutated IgV genes, whereas 57% (n = 12) of CD38⁺/ZAP-70⁺ samples were unmutated. Horizontal lines represent the mean of all measured values in the corresponding group. (C) CD38⁺/ZAP-70⁺ patients required more treatment compared with CD38⁻/ZAP-70⁻ patients. While 85% (n = 17) CD38⁻/ZAP-70⁻ patients were either untreated (NT) or treated with chorambucil monotherapy (CHL), CD38⁺/ZAP-70⁺ patients required polychemo- or combined immunochemotherapy (T) in 52% (n = 11) of patients.