Implications of the increased expression of CD38 on trisomy 12 CLL cells. (A) The proportion of cells that express CD38 is increased in trisomy 12 cases. (B) NOTCH1 mutation status had no impact on the expression of CD38 in trisomy 12 cases. (C) CD38 is not a surrogate marker of IGVH mutation status in patients with trisomy 12. (D) In contrast, increased expression of ZAP70 retains its association with IGVH mutation status in patients with trisomy 12. Treatment-free survival curves for CLL patients with trisomy 12 with a 40% cutoff for CD38 positivity (E).