The Clinical Relevance of Lymphocyte Surface Markers in Adult Acute Lymphoblastic Leukemia

Bloomfield, Clara D.

doi:10.1007/978-94-009-7433-3_9

Cited by 8 publications

(3 citation statements)

References 115 publications

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“…The presenting features of our patients were similar to those reported in adult and childhood L1 ALL (Bloomfield et al, 1982, 1986: Gill et al, 1986Murphy et a/, 1986;Patte et al, penetration (Balis et al, 1985) and CNS irradiation. The epipodophyllotoxins VM26 and VP16, which have been added to the induction course by two groups (Feickert et al 1987: Vassal et al, 1986) also seem to have a good CNS penetration (Postmus et ul, 1984).…”

Section: Discussionsupporting

confidence: 86%

“…The prognosis of L3 ALL has been consistently found very poor, particularly in adults: only 20% (Gill et al, 1986) to 40% (Bloomfield, 1982) of the adult patients reaclh CR, versus 80% of children (Bloomfield et al, 1986). Furthermore, most adults and children experience early relapses, particularly in the CNS, and less than 20% have a long survivall (Bloomfield et al 1986;Gill et al, 1986).…”

Section: Discussionmentioning

confidence: 99%

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Burkitt cell acute leukaemia (L₃ ALL) in adults: a report of 18 cases

Fenaux¹,

Laı̈²,

Miaux³

et al. 1989

Br J Haematol

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Summary Between 1981 and 1987, L3 ALL was diagnosed in 18 adult patients, with a median age of 26 (range 16‐66) and M/F ratio of 3.5. At diagnosis, 11 patients had splenomegaly, 11 had enlarged lymph nodes, and 15 patients had central nervous system (CNS) disease, of whom 10 had mental neuropathy. Anaemia was found in 13 patients, thrombocytopenia in 17 and the median white cell count was 25.5 × 109/1(range 8.6‐89). Surface immunoglobulins were found on the blasts of every patient. Seventeen patients had a t(8;14) (q24;q32) translocation. One had an apparently normal karyotype, but only six mitoses could be examined. During the period of the study different treatment protocols, which comprised increasingly intensive systemic and CNS chemotherapy, were used. Six patients died less than 3 weeks after admission, two of them of acute tumour lysis syndrome and two of CNS haemorrhage. In two other patients, rapid progression of CNS leukaemia was seen in spite of the treatment. Ten patients (56%) achieved complete remission (CR). Two were allografted and two were autografted early in CR. Four patients relapsed, three of the four relapses involving the CNS. A median actuarial disease‐free survival was not attained, and a plateau was achieved at 57% after 7 months, with no later relapse. Median actuarial survival of the 18 patients was only 6 months, but a plateau was obtained at 31% after 11 months. Prognosis seemed related to the intensity of chemotherapy: recent patients, treated more aggressively, achieved CR more often than earlier patients, treated with less intensive protocols, although the number of patients was too small to draw any firm conclusion. The initial white cell count was also a prognostic factor, as none of the patients with more than 30 × 109/1 leucocytes achieved CR. Our results suggest that the outcome of adult L3 ALL can be improved, as in children, by increased intensity of treatment, particularly with regard to CNS leukaemia therapy. Early deaths are still frequent, however, but their incidence can probably be reduced by better prevention and early management of the acute tumour lysis syndrome.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Burkitt cell acute leukaemia (L₃ ALL) in adults: a report of 18 cases

Fenaux¹,

Laı̈²,

Miaux³

et al. 1989

Br J Haematol

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“…Survival of patients with a low CBE was not different from the patients without CBE, suggesting that few circulating clonal B cells are of no prognostic importance. This is in accordance with findings in chronic lymphocytic leukemia and acute leukemias, where high numbers of leukemic blood cells are associated with a poor prognosis (16,17). Knowledge of prognostic factors in malignant diseases is important to a) identify high-risk patients who need an intensified therapy to improve prognosis, and b) to compare patient materials in clinical trials.…”

Section: Discussionsupporting

confidence: 85%

Blood clonal B cell excess at diagnosis in multiple myeloma: Relation to prognosis

Österborg

Nilsson²,

Björkholm

et al. 1987

European J of Haematology

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112 patients with multiple myeloma have been studied at diagnosis for the presence of blood clonal B‐cell excess (CBE), defined as a ratio between k+ and λ+ lymphocytes outside the normal range (0.9‐3.5). 48 patients (43%) had CBE. The increase in light chain‐bearing lymphocytes was always that of the M component light chain isotype. The proportions of patients exhibiting CBE were the same in different stages. The response frequency was not influenced by the presence of CBE. However, patients with CBE had a shorter remission duration time (p < 0.001) and total survival (p < 0.05) than those without CBE. This was also noticed when each clinical stage was analyzed separately. Moreover, survival was shorter in patients with a large fraction of CBE than in those with a small one. Cox regression analysis revealed that CBE was a much stronger predictor of remission duration than age, clinical stage and renal dysfunction. CBE and response to initial treatment independently were the best factors to indicate survival. It is suggested that analysis of CBE should be included in the clinical characterization of untreated patients with multiple myeloma.

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