Incidence and Clinical Relevance of Myeloid Antigen-Positive Acute Lymphoblastic Leukemia

Drexler, Hans; Ludwig, Wolf‐Dieter

doi:10.1007/978-3-642-84895-7_6

Cited by 56 publications

(68 citation statements)

References 41 publications

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“…29 Although the various BCR-ABL transcripts are known to have different oncogenic potential in vitro as well as in animal models, 30,31 the biological differences between p190 and p210 remain enigmatic in ALL patients. There is an overlap of the disease spectra associated with the different BCR-ABL fusion proteins 32 also concerning expression of myeloid markers of ALL blasts, 33 and a high incidence of BCR-ABL products was recorded in the situation of hybrid leukemia in this study.…”

Section: Discussionmentioning

confidence: 52%

Prospective BCR-ABL analysis by polymerase chain reaction (RT-PCR) in adult acute B-lineage lymphoblastic leukemia: reliability of RT-nested-PCR and comparison to cytogenetic data

et al. 2001

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Section: Discussionmentioning

confidence: 52%

Prospective BCR-ABL analysis by polymerase chain reaction (RT-PCR) in adult acute B-lineage lymphoblastic leukemia: reliability of RT-nested-PCR and comparison to cytogenetic data

et al. 2001

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“…[10][11][12][13][14][15] However, more recent studies have shown that by far the majority, if not all, precursor B-ALL cells display immunophenotypic features which are usually not detected in the normal bone marrow B cell precursors -the so-called phenotypic aberrations. [19][20][21][22][23] Accordingly, cross-lineage antigen expression and aberrant patterns of B cell maturation are usually detected in these patients. Based on these findings, it has been suggested that these leukemia-associated phenotypes could reflect, at least to a certain extent, the genetic aberrations present in the leukemic cells; accordingly for those patients displaying an identical genetic lesion, a similar phenotypic behavior could be expected.…”

Section: Discussionmentioning

confidence: 99%

“…[16][17][18] However, in recent years several reports have shown that in most precursor B-ALL cases neoplastic cells display aberrant phenotypes. [19][20][21][22][23] Some of these leukemia-associated phenotypes have been associated with specific genetic abnormalities. [24][25][26][27][28][29] In this regard, large multicentric studies have been conducted in order to explore the potential existence of an association between specific cytogenetic abnormalities such as the t(1;19)(q23;p13) [30][31][32] and t(4;11)(q21;p23) 33,34 translocations and peculiar phenotypes of leukemic B cells.…”

Section: Introductionmentioning

confidence: 99%

Quantitative multiparametric immunophenotyping in acute lymphoblastic leukemia: correlation with specific genotype. I. ETV6/AML1 ALLs identification

et al. 2000

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The t(12;21)(p13;q22) fusion gene is the most frequent genetic lesion described in precursor B cell acute lymphoblastic leukemia (ALL) of childhood occurring in a quarter of cases. This gene rearrangement is associated with a good outcome presenting a high response rate to chemotherapy. In spite of its potential clinical relevance, the t(12;21) translocation usually goes undetected with conventional cytogenetic procedures. In the present study we utilized an objective flow cytometric approach (multiparametric quantitative analysis) for the phenotypic characterization of this type of ALL. We studied a total of 74 precursor B-ALL children, including 21 t(12;21) + and 53 t(12;21) − cases. Our results show that the t(12;21)(p13;q22) + ALLs display a higher intensity of CD10 (P = 0.0016) and HLADR (P = 0.005) expression together with lower levels of the CD20 (P = 0.01), CD45 (P = 0.01), CD135 (P = 0.003) and CD34 (P = 0.03) antigens as compared to the t(12;21) − cases. Moreover, as regards CD34 expression, we observed a more heterogeneous antigen expression within individual patients with higher coefficients of variation (median of 202 vs 88, P = 0.0001). A multivariate analysis disclosed that with the immunophenotypic approach used identification of t(12;21) + cases can be achieved with a sensitivity of 86% and a specificity of 100%. We conclude that childhood precursor B-ALL carrying the t(12;21) translocation display characteristic phenotypic features which could provide a rapid, simple, sensitive and specific screening method to select for those cases that should undergo confirmatory molecular analysis. Leukemia (2000) 14, 1225-1231.

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“…[15][16][17] The literature suggests that the incidence of CD13 and/or CD33 positivity is in the order of 5-10% in children and in up to 20% of adult cases. 18 In the UKALLXI trial the overall incidence of such positivity among cases tested was 17%, with only 13% of T cell cases being positive and the highest incidence at 29% occurring in the early pre-B or null cell cases. It has been emphasised that these cases should be clearly differentiated from the rarer cases where two distinct myeloid and lymphoid cell populations exist, or where the cells are undifferentiated by conventional morphological and cytochemical criteria, but clearly express markers of different lineages.…”

Section: Figurementioning

confidence: 99%

Analysis of the immunophenotype of children treated on the Medical Research Council United Kingdom Acute Lymphoblastic Leukaemia Trial XI (MRC UKALLXI)

Hann

Richards²,

Eden

et al. 1998

Leukemia

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Despite many years of meticulous immunophenotyping of childhood acute lymphoblastic leukaemia (ALL) cases the prognostic significance of some subtypes remains unclear. The Medical Research Council UKALLXI trial (1990)(1991)(1992)(1993)(1994)(1995)(1996) in which uniform treatment has been given to 2090 children with ALL below the age of 18 years and above the age of 1 year, has afforded the opportunity to review these issues. Children with ALL of mature B cell type were not entered into this trial. Immunophenotype analysis was performed in each individual trial centre, but results were centrally reviewed in all cases, and were both available and considered adequate in 1934 (93%) of the first 2090 patients entered. The main diagnostic categories were early pre-B or null reported in 60 cases (3.1%), common ALL in 1242 (64.2%), pre-B in 252 (13.0%), 'common' or pre-B in 172 (8.9%) and T cell in 207 (10.7%) cases. Children with T cell disease were significantly more likely to be over the age of 10 years, with central nervous system disease at diagnosis and to be CD34 negative. They also had a higher incidence of high white cell count and were more likely to be of the FrenchAmerican-British (FAB) L2 morphological subtype. Patients with 'null' cell disease tended to be less than 2 years or greater than 10 years of age, and CD13 and CD33 positive. CD10 was associated with lower white cell count (WBC) at diagnosis, younger age and FAB L1 morphological subtype. The presence of cytoplasmic immunoglobulin in pre-B cells was not associated with any specific clinical or laboratory features. CD34 positivity was less common in T cell patients and was associated with low WBC. Disease-free survival (DFS) and 95% confidence intervals (CI) at 5 years from diagnosis was 52% (95% CI: 44-59%) for T cell disease, 58% (95% CI: 43-73%) for early pre-B (or null cell) disease and 65% (95% CI: 62-68%) for common or pre-B disease; there being no significant difference between common and pre-B disease with regard to disease outcome. Patients with T cell disease had a worse prognosis than any other immunophenotype group (P Ͻ 0.00005). However this worse outcome was no longer significant after allowing for the other principal prognostic factors of age, gender and white cell count at diagnosis except for the very small number with WBC Ͻ20 × 10 9 /l and T cell disease. Those with CD10-positive leukaemia did better than those who were CD10 negative (P Ͻ 0.00005), with DFS at 5 years 64% (95% CI: 62-67%) for positive vs 56% (95% CI: 49-62%) for CD10 negative. CD10 positivity did not have independent significance when white count, gender and age were taken into account. CD13, CD33, and cytoplasmic positivity carried no prognostic significance. Keywords: immunophenotype; prognosis; acute lymphoblastic leukaemia (ALL); children IntroductionImmunological heterogeneity of ALL has been recognised for many years. ing which time the use of standardised panels of antibodies has permitted allocation of more than 98% of leukaemias to their respective lineage...

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Incidence and Clinical Relevance of Myeloid Antigen-Positive Acute Lymphoblastic Leukemia

Cited by 56 publications

References 41 publications

Prospective BCR-ABL analysis by polymerase chain reaction (RT-PCR) in adult acute B-lineage lymphoblastic leukemia: reliability of RT-nested-PCR and comparison to cytogenetic data

Prospective BCR-ABL analysis by polymerase chain reaction (RT-PCR) in adult acute B-lineage lymphoblastic leukemia: reliability of RT-nested-PCR and comparison to cytogenetic data

Quantitative multiparametric immunophenotyping in acute lymphoblastic leukemia: correlation with specific genotype. I. ETV6/AML1 ALLs identification

Analysis of the immunophenotype of children treated on the Medical Research Council United Kingdom Acute Lymphoblastic Leukaemia Trial XI (MRC UKALLXI)

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