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Query: UMLS:C0023418 (leukemia)
 93,477 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The immunologic and clinicopathologic features of common acute lymphoblastic leukemia antigen (CALLA)-positive and CALLA-negative T-acute lymphoblastic leukemia (ALL) and of CALLA-positive non-T, non-B ALL (common ALL) of childhood were compared. Twenty-seven percent of children with T-ALL had blasts that expressed CALLA. This expression was not associated with a significantly different incidence of expression of sheep erythrocyte-rosette receptors, glucocorticoid receptors, peanut agglutinin receptors, or T-cell antigens. CALLA-positive T-cell blasts were more likely to express a p24 leukemia-associated antigen (CD9, 50% versus 8%) and Ia antigens (39% versus 8%) than were CALLA-negative blasts. Patients with CALLA-positive and CALLA-negative T-ALL had similar clinicopathologic features at diagnosis. In contrast, compared to patients with common ALL, patients with CALLA-positive T-ALL were older, had higher leukocyte counts, and an increased incidence of splenomegaly, lymphadenopathy and mediastinal mass, similar to patients with CALLA-negative T-ALL. Patients with CALLA-positive T-ALL were more likely to achieve a complete remission (95% versus 83%, P = 0.055) and tended to have an increased duration of event-free survival (P = 0.07) than did patients with CALLA-negative T-ALL. The expression of T-cell antigens is more important than the expression of CALLA in defining biologically similar subgroups of childhood ALL. Preliminary evidence suggests that within T-ALL the expression of CALLA may be prognostically important.
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PMID:Immunologic and clinicopathologic features of common acute lymphoblastic leukemia antigen-positive childhood T-cell leukemia. A Pediatric Oncology Group Study. 295 60

To increase our knowledge of the clonal relationship of leukaemia relapse, the genotypes and phenotypes of ten children with acute lymphoblastic leukaemia (ALL) were examined at initial diagnosis and relapse. Seven patients were phenotyped as common ALL, two as mixed, and one as T-cell ALL (T-ALL). Comparative analyses of immunoglobulin (Ig) heavy and light chain as well as T-cell receptor beta-chain (T beta) sequences revealed clonal variations, i.e. appearance of a novel or an evoluted leukaemic cell clone in five patients coinciding with the loss of common acute lymphoblastic leukaemic antigen (CALLA) in four cases, irrespective of early or late relapse. Conversion of early B- to T-ALL or lymphoblastic to non-lymphoblastic leukaemia was not noted in any of the patients examined. Our results suggest that clonal variation is a frequent event in childhood ALL.
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PMID:Clonal variation in childhood acute lymphoblastic leukaemia at early and late relapse detected by analyses of phenotype and genotype. 297 Mar 90

Increased birth weight previously has been reported to be associated with childhood acute leukemia although the etiologic importance of this finding remains unclear. To further assess birth weight and associated parameters as a risk factor for childhood leukemia, a case/control study was performed using children with acute lymphoblastic leukemia (ALL) born in the state of Minnesota and diagnosed since 1969. Data obtained from birth registrations of 219 cases were compared with two control groups matched on date and county of birth (group I) or year of birth (group II). No significant differences were observed in mean birth weights of cases and controls. Statistically significant associations with birth weights greater than 3800 g were identified in cases diagnosed within the first 4 years of life. No associations were found between birth weight and ALL for case children diagnosed after 4 years of age. Factors that might be associated with increased birth weight, including maternal age, birth order, length of gestation, and socioeconomic status as measured by paternal education, were not found to be associated with an increased risk for ALL. The significance of the finding of high birth weight as a risk factor for childhood ALL remains unknown but suggests that pregnancy-related events may be of importance in the etiology of ALL in young children.
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PMID:Birth weight as a risk factor for childhood acute lymphoblastic leukemia. 315 13

For patients with an initial diagnosis of Philadelphia chromosome (Ph1)-positive acute lymphoblastic leukaemia (ALL) and no documented history of Ph1-positive chronic myeloid leukaemia (CML), the cell of origin and extent of lineage involvement of the disease is often unclear. This is largely due to the fact that cytogenetic analysis of direct marrow preparations cannot distinguish between the presence of Ph1-positive myeloid metaphases and infiltration of the marrow with dividing Ph1-positive blasts. Cytogenetic analysis of cultured haemopoietic colonies allows more precise lineage assignment. We have used this approach to study five adult patients who presented with Ph1-positive ALL and subsequently showed a significant increase in normal metaphases (to 18-100% of all metaphases examined) following remission induction. In four of these five patients, some Ph1-positive erythroid and granulopoietic cells could be demonstrated. In the other, as in three patients with childhood ALL who presented with a Ph1-negative but cytogenetically abnormal clone, only chromosomally normal erythroid and granulopoietic progenitors were detected. Two Ph1-positive CML patients who entered a lymphoid blast crisis following a recognized chronic phase were also studied. In both of these latter two patients all erythroid and granulocyte-macrophage colonies analysed were Ph1-positive. These findings support the concept that patients presenting with Ph1-positive ALL comprise a heterogeneous group. In some cases the disease may arise in a restricted lymphopoietic cell not capable of myelopoietic differentiation. However, in others involvement of myeloid cells suggests these may be variant forms of CML in spite of an unusual initial response of the Ph1-positive clone to therapy.
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PMID:Cytogenetic studies of haemopoietic colonies from patients with an initial diagnosis of acute lymphoblastic leukaemia. 317 28

A possible association between HLA antigens, susceptibility or resistance to leukemia, and responsiveness to treatment has been studied in 144 patients with childhood acute lymphoblastic leukemia (ALL) and compared to other prognostic factors, i.e. white blood cell (WBC) counts, age at onset, sex, ethnic origin, and cell surface markers. All sequentially newly diagnosed children (97) comprised the group for the prospective study (PSG) and were followed for 6 years. The group included 37 patients classified as T-ALL, 41 as CALLA+, 27 as NULL, 12 as B and pre-B, and 27 unclassified patients, who were diagnosed before 1980. During the follow-up period, 45 patients of the PSG died. Forty-seven patients designated long-term survivors (LTS) have been followed 6-20 years after diagnosis, having completed a 3-5 year course of anti-leukemia therapy, and having remained disease free thereafter. High WBC counts at diagnosis and T-cell-surface markers were associated with poor prognosis, as were enthnic origin and specific HLA antigens. Thus, there was one (1) a significant increase in HLA-A30 and a decrease in HLA B-14 in the PSG Jewish patients; and (2) a complete absence of HLA-ALL in LTS while, in the PSG, 8 of 9 HLA-All-positive patients died during the follow-up period. This suggests that HLA-All is associated with poor prognosis in childhood ALL.
Leukemia 1988 Dec
PMID:HLA-A11 is associated with poor prognosis in childhood acute lymphoblastic leukemia (ALL). 319 82

The structure of immunoglobulin heavy chain (IgH) and T cell antigen receptor (TCR) beta and gamma chain genes was studied in 38 cases of adult and two cases of childhood acute lymphoblastic leukemia (ALL). Seven cases of T-ALL all showed clonally rearranged TCR beta and gamma genes; only one of these also contained rearranged IgH genes. All precursor B cell ALLs and one case of unusual B cell ALL/lymphoma had clonally rearranged IgH genes, but a high proportion (22 of 32, 69%) of precursor B cell ALLs also had rearrangement of TCR beta and/or gamma genes. TCR beta gene rearrangement was less common in more mature precursor B cell ALL, expressing cytoplasmic IgM (pre-B-ALL) (0 of 5) than in other precursor B cell ALL cases (15 of 27). In the precursor B cell ALLs overall, 10 (32%) had rearrangement of both beta and gamma genes, while 7 (22%) had rearrangement of TCR gamma genes only. A further 5 (16%), all expressing one or more unusual immunophenotype markers, had TCR beta gene rearrangement without detectable gamma gene rearrangement. These observations, together with certain characteristics of constant-joining region usage of both TCR genes (a preference for rearrangement into the C beta 2 and C gamma 1 genes), distinguishes these "inappropriate" rearrangements from those found in T-ALL and suggests that they have arisen through a differentiation arrest which is not part of a normal T cell developmental program.
Leukemia 1988 Jan
PMID:Correlation of immunophenotype with rearrangement of T cell antigen receptor beta and gamma genes in acute lymphoblastic leukemia of adults. 325 38

The identification of ALL immunophenotypes with distinctive clinical features and prognostic significance indicates the importance of these studies in the evaluation of ALL patients for both clinical and research purposes. For differential diagnosis, the expression of pan-B-cell or pan-T-cell lymphoid antigens and the absence of myeloid/monocyte antigens represent the most useful markers for distinguishing ALL from AML. However, the increasing appreciation of large numbers of patients with clinically significant mixed lymphoid-myeloid phenotypes suggests that rigid classification of acute leukemias into exclusive lymphoid and myeloid categories may be somewhat artificial. In adult ALL, patients with My+ phenotypes (B+sIg-T-My+ and B-sIg-T-My+) have a lower incidence of complete remission and shorter survival times than do patients with My- marker profiles. Preliminary studies in childhood ALL also suggest a correlation between myeloid antigen expression and poor prognostic factors. In addition, children with sIg+ "B-cell," cIg+ "pre-B-cell," and T-cell ALL phenotypes have shorter disease-free survival times than do patients with more common "early pre-B" (B+cIg-sIg-T-) marker profiles. Application of immunologic markers in concert with cytogenetic and gene rearrangement studies has led to the identification of novel subgroups of leukemia with distinct clinical characteristics. Future studies incorporating a multiparameter diagnostic approach including immunophenotyping, gene rearrangement studies, and karyotypic analyses should further our understanding of the heterogeneity of acute leukemias, guide the development of new therapeutic strategies, and provide for more clinically relevant classification of these disorders.
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PMID:Immunophenotyping in the diagnosis and classification of acute lymphoblastic leukemia. 328 57

During the past decade enormous progress has been achieved in the investigation of cytogenetics and moleculargenetics of leukemia and lymphoma, although there have been few systemic studies which clarify genetic etiology leukemia. At this standpoint it is important to review the recent literature which concerns etiology of leukemia. Recently it has been proved that of the incidence of childhood acute lymphocytic leukemia is same in all over the world by Greaves and his collegue. So the major cause of childhood leukemia can be explained to be spontaneous mutation. Nevertheless genetic factors are thought to be a part of another cause of leukemia as well as certain environmental factors. Heterogeneity of genetic mechanism in familial aggregation in each case probably makes difficult to analyse the cause of hereditary mechanism in leukemia.
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PMID:[Genetic epidemiology of the familial aggregation of human leukemia]. 329 15

In childhood acute lymphoblastic leukemia, univariate analyses have identified more than thirty clinical and laboratory prognostic factors. Multivariate analysis is used to sort out the most independent and predictive of these factors, but the methods used are mathematically and conceptually complex. In this report, we depict the interactions between multiple variables graphically using 3-dimensional data displays. This approach helps conceptualize the multivariate process and provides an alternative method. We applied the method to the 2,987 children in the CCG-160 series of studies, and specifically to the "high-risk" subgroups: initial white cell count (WBC) greater than 50,000/microliter; white count greater than 50,000/microliter in conjunction with a mediastinal mass; age at diagnosis less than 1 year; and, central nervous system (CNS) leukemia at diagnosis. Analyzed in this fashion, T-cell immunophenotype, the presence of a large mediastinal mass, CNS leukemia, and the lymphomatous pattern lose their prognostic value when outcome is stratified by age and WBC. The 3-dimensional method confirms the mathematical analyses and provides graphic evidence for the conclusions.
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PMID:The staging of childhood acute lymphoblastic leukemia: strategies of the Childrens Cancer Study Group and a three-dimensional technic of multivariate analysis. 346 99

The outcome of sixteen treatment programs for childhood acute lymphocytic leukemia reported by cooperative study groups were reviewed and analysed. The rate of disease-free survival for 3 years or more ranged from 34% to 75%, depending on each clinical trial. Remission induction therapy always consists of at least vincristine (V) and prednisone (P). L-asparaginase or daunorubicin is generally added to VP therapy. The following central nervous system (CNS) prophylaxis therapies were compared: craniospinal irradiation cranial irradiation (either 2400 rads or 1800 rads) plus intrathecal methotrexate, intrathecal drugs (either methotrexate alone or so-called triple therapy consisting of methotrexate, cytosine arabinoside and hydrocortisone) and intermediate- or high-dose methotrexate plus intrathecal methotrexate. These therapies have reduced the incidence of CNS leukemia to less than 10%. The intensification phase was the most variable component of treatment. In order to obtain maximum leukemic cell killing early in treatment, a number of protocols are investigating the use of an intensive consolidation course. An early consolidation study by the Berlin-Munster-Frankfurt group in West Germany achieved successful results. However, intensive therapy for low-risk patients failed to improve the disease-free survival. Further studies will be needed to assess the effectiveness of prolonged intensification for patients having any of the prognostic risk features. The standard duration of therapy varies between 2 and 3 years, but the minimum duration of effective chemotherapy is still unknown. It should be clarified whether a more intensive chemotherapy, can facilitate a shorter duration of treatment.
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PMID:[End results and comparative analysis of treatment programs for childhood acute lymphocytic leukemia]. 346 55


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