Clinical Significance of TdT, Cell Surface Markers and CFU-C in 297 Patients with Hematopoietic Neoplasias

Mertelsmann, Roland; Koziner, Benjamín; Filippa, Daniel A.; Grossbard, Elliot; Incefy, Geneviève S.; Moore, MA; Clarkson, BD

doi:10.1007/978-3-642-67057-2_16

Cited by 7 publications

(3 citation statements)

References 19 publications

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“…It is important to emphasize that cases of acute 'undifferentiated' leukaemia positive for TdT or common-ALL associated anitgen were not included in our study. These are considered, on the basis of enzyme or membrane marker observations, as variants of childhood or adult ALL (Janossy et al, 1980), and may include many of the cases of acute leukaemia, with equivocal morphology, which responded well to vincristine-prednisone therapy in other serial studies (Mertelsman et al, 1979). In contrast, the third patient group identified in our study, that is, acute leukaemias with unequivocal signs of myeloid differentiation and greater than 5% TdT positive cells, appeared to represent a particularly poor prognostic category.…”

Section: Discussionmentioning

confidence: 99%

Terminal Deoxynucleotidyl Transferase Expression in Acute Non‐lymphoid Leukaemia: an Analysis by Immunofluorescence

et al. 1981

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Indirect immunofluorescence for terminal transferase enzyme (TdT) was used to study the blasts of 64 patients with acute non-lymphoid leukaemia (ANLL). In 32 patients no TdT positive cells were seen. In 19 cases a small subpopulation of cells expressing TdT was detected; these constituted up to 5% of total nucleated cells, and it was not clear whether these TdT positive cells were part of the leukaemic process or represented residual normal bone marrow lymphoid cells. The remaining 13 patients had TdT positive cells accounting for 7-90% of the total. In two of these cases TdT was expressed on blasts with myeloid features, representing an aberrant expression of TdT by myeloid cells; in contrast, in three cases mixed populations of TdT positive lymphoid blasts and TdT negative myeloid blasts were observed. In the remaining cases it was not possible to determine whether the TdT positive cells had definite lymphoid or myeloid features. Cytogenetic analysis showed no evidence of the Philadelphia chromosome. Response to treatment was assessed in 11 of the 13 patients. Only one patient remitted with the initial choice of therapy (DAT); four failed to respond to initial regimes of vincristine and prednisone (V & P) while the other five patients did not respond to myelotoxic combinations (DAT). Only one patient subsequently entered complete remission on second line therapy (V & P). This group of patients with TdT+ ANLL had a particularly bad prognosis, and appeared to differ from cases of TdT positive acute undifferentiated leukaemia, which often respond to V & P therapy.

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Section: Discussionmentioning

confidence: 99%

Terminal Deoxynucleotidyl Transferase Expression in Acute Non‐lymphoid Leukaemia: an Analysis by Immunofluorescence

et al. 1981

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“…Diese Differenzierung in Gegenwart von Thymopoetin führt zur Expression z.B. des HTLA-Antigens beim Menschen (34) oder von Thy-l-Antigen bei der Maus (40) und geht mit dem Absinken der TdT-Aktivität einher (33,34). Die TdT-positiven Thymozyten sind unreife, immunologisch inkompetente Zellen, die weder auf Mitogene noch auf Alloantigene reagieren, jedoch corticosteroid-sensitiv sind (2, 17,18,26).…”

Section: Tdt In Gesundem Gewebeunclassified

“…Myeloische Stamrnzellen (CFU-c) weisen keine TdT-Aktivität auf (30,34). Auch normale Zellen der myeloischen Reihe wie z.B.…”

Section: Tdt In Gesundem Gewebeunclassified

Die Bedeutung der Terminalen desoxynukleotidyl Transferase in der Diagnostik der akuten Leukämie des Kindes - Ergebnisse von 63 Patienten

Welte¹,

Ebener²,

Hinderfeld³

et al. 1981

Klin Padiatr

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Terminal deoxynucleotidyl transferase (TdT) was examined in mononuclear peripheral blood cells (pB) and bone marrow (BM) specimens of 63 children with acute leukemia (AL). The enzyme activity in normal specimens (pB, BM) was below 0.2 U/10(8) cells; whereas, 49 of the 52 children with acute lymphoblastic leukemia (ALL) at diagnosis showed an activity in the range 1.2--60 U/10(8) cells. 2 of the remaining 3, devoid of TdT activity, were found to be B-cell leukemia. Patients with acute non-lymphoblastic leukemia (ANLL) were generally TdT-negative. Elevated level of TdT activity was detected in only one of 11 children with ANLL. In one patient with acute leukemia two distinct populations of cells with lymphoblastic (87%) and myeloblastic characteristics were evident. The clinical course and cell marker studies were consistent with the interpretation of a defect at the level of the common stem cell giving rise to a TdT-positive lymphoblastic cell population at diagnosis and, following the initial ALL-therapy (4 weeks), a predominant TdT-negative myeloblastic population. TdT as a marker for the modulation of chemotherapy was examined in the remission phase of the disease. Of the nine patients in the first 3 months of remission, one was found to have elevated level of TdT activity (2.5 U/10(8) cells). These data define the usefulness of TdT in the classification of acute leukemia.

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Summary of Clinical Poster Sessions

Ph¹

1979

Modern Trends in Human Leukemia III

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Clinical Significance of TdT, Cell Surface Markers and CFU-C in 297 Patients with Hematopoietic Neoplasias

Cited by 7 publications

References 19 publications

Terminal Deoxynucleotidyl Transferase Expression in Acute Non‐lymphoid Leukaemia: an Analysis by Immunofluorescence

Terminal Deoxynucleotidyl Transferase Expression in Acute Non‐lymphoid Leukaemia: an Analysis by Immunofluorescence

Die Bedeutung der Terminalen desoxynukleotidyl Transferase in der Diagnostik der akuten Leukämie des Kindes - Ergebnisse von 63 Patienten

Summary of Clinical Poster Sessions

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