Incidence, clinical characteristics and early treatment outcome in Indian patients of childhood acute lymphoblastic leukemia with ALL1 gene rearrangement (original) (raw)
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IOSR Journals , 2019
Leukemia, also spelled leukaemia, is a group of blood cancers that usually begin in the bone marrow and result in high numbers of abnormal blood cells. Acute lymphoblastic leukaemia is characterized by the proliferation of lymphoid cells but represents indeed a heterogeneous group of diseases that vary with respect to the morphological, cytogenetic, molecular and immunologic features of the neoplastic cells. The acute leukaemia are defined pathologically as blast cell leukaemia or malignancies of immature hacmopoitic cells which show >30% blast cells in the bone marrow On the basis of clinical findings and peripheral blood film study thesuspected cases of acute leukcmias whose age group between 2yrs to l2yrs were included. Total 30 patients of leukaemia of both sexes were selected for this study. After clinical diagnosis a complete blood count with film (CBC) was done for every patient and subsequently the diagnosis was confirmed by bone Marrow study and also, immunophenotype was done. Detailed clinical informations were obtained by meticulous history taking and through physical examination. Relevant investigations were also f enrolled as per prescribed proforma.Bone marrow aspiration was done by Salah marrow puncture needle. 2% lignocaine used as local anesthesia. Aspiration was done from posterior superior iliac spine sometimes from anterior superior iliac spine.Films were made, 3-5cm in length of the aspirated marrow using a smooth edge glass spreaded of not more than 2cm in width. The marrow fragments were dragged behind the spreader and left a trail of cells behind them.. About 80-85% of childhoor acute lymphoblastic leukaemias (ALL) represent leukemic transformation of lymphocytes arrested at a primitive Stage of development, but nevertheless already committed to the B-lymphocyte pathway. Thoseleukemias derived from the most mature B-lymphocytes are eharacterized by the presence of immunoglobulin on the leukemic cell Surface; they tenthly represent less than 4% of childhood acute lymphoid leukemias. A total of 30 patients were studied in this study. Among them majority arc between 5 to 8 years of age (56.66%). There are male predominance (73.33%). Fever is present almost in 100% cases. Bone pain in 73.33% cases, bleeding manifestation in 76% cases and 60% patient presented with lymphadenopathy. 60% patients have hepatomegaly and 79% pt have splenomegaly. In 40% cases Hb% was 5 to 6 gmIdL and in 33% cases Hb% was 7 to 8 gmIdl. A study was done previously by Dr.BclayetHossain in Dhaka Shishu Hospital that showed Fever, and pallor in (88%), hepatomegaly (75%), Splenomegaly 67%, Lymphadenopthy (76%), bleeding manifestation (50%), Another report by Iloflbrand 1 showed Lymphadenopathy (65%), bone pain (50%). This study reveals that in addition to Morphological study of bone Marrow; Immunophenotyping is also required to know the specific Lineage marker which will help to choose the specific chemotherapy schedule and also the prognosis of the patient.
2006
An 18-month-old girl was diagnosed with prepre-B ALL/t(4;11) leukemia, which during the treatment and after matched bone marrow transplantation (BMT), underwent two consecutive switches from lymphoid to myeloid lineage and vice versa. The high expression of HOXA9 and FLT3 genes remaining genotypically stable in a leukemia throughout phenotypic switches, suggests that this leukemia may have originated as a common B/myeloid progenitors. Haematologica 2006; 91:(2)e29-e31 C Ca as se e r re ep po or rt t An 18-month-old girl was admitted to the San Giovanni Rotondo Casa Sollievo della Sofferenza IRCCS Hospital presenting with a WBC of 201,000/mm 3 (80% blasts), hemoglobin of 7.1 g/dL, and platelet count of 42,000/mm 3 . After obtaining informed consent from the patient's parents, a bone marrow (BM) aspirate was performed. The sample was submitted to the University of Padua's Laboratory of Pediatric Onco-Hematology laboratory, as National reference laboratory for all pediatric leukemias enrolled in the AIEOP protocols, for morphologic, cytochemical, cytogenetic, molecular, and flow cytometric evaluations. The BM aspirate contained 95% of tumor cells having the morphology of lymphoblasts (French-American-British [FAB] L1) ( ). Flow cytometric immunophenotypic analysis of blast cells showed: CD19+, CD34+, CD45+, CD133+, CD135+, NG2+, TdT+, HLA-DR (bright) ( . Conventional cytogenetic analysis revealed 46, XX, t(4;11)(q21;q23) in all 20 metaphases analyzed. RT-PCR analysis showed the presence of two amplified MLL-AF4 fusion transcripts ( ). The diagnosis of pre-pre-B ALL was made.
Immunophenotyping Pattern in Childhood Acute Leukemia in the Adam Malik Hospital Medan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY
Leukemia is the most common malignancy at the age of under 15 years, with a ratio of 1 to 3 cancer cases in children.Immunophenotyping will improve accuracy and easily provide data reproducibility. To determine the immunophenotypingpattern in patients with acute leukemia in the Pediatric Center at the Adam Malik General Hospital, Medan. This research wasa cross-sectional study in children suffering from acute leukemia in the Pediatric Unit Adam Malik General Hospital, Medanbased on CBC, peripheral smear, bone marrow morphology, and flow cytometry immunophenotyping. Samples wereevaluated for blast morphologic and immunophenotyping was carried out. Results of morphologic observation andimmunophenotyping were compared. From 20 samples using the monoclonal antibody with flow cytometryimmunophenotyping, concordance with morphology is good (κ = 0.886). After classification, the percentage of acuteleukemia was 45% B-ALL, 35% AML, and 20% T-ALL. One of 10 samples morphologically classified...
International Journal of Collaborative Research on Internal Medicine and Public Health
Introduction: Leukemia accounts for 0.15 – 0.6% of the total medical admissions in many general hospitals in India. Frequency of leukemia seen in India of Acute Myeloid leukaemia (AML) is 20 -25% and Acute Lymphoblastic leukaemia (ALL) is 15-25%. The Annual incidence rate of AML and ALL are 5.6 and 30.9 per million population respectively.
Immunological typing of acute lymphoblastic leukaemia
Scandinavian journal of haematology, 1983
The blasts of 37 adult and 126 childhood cases of acute lymphoblastic leukaemia (ALL) were characterized with a panel of xeno-antisera and rosette tests. The Orthoclone monoclonal antibodies (OK series) were applied as well. Like other investigators, we were able to distinguish 4 major classes of ALL: T-ALL, common-ALL with the subclass pre-B-ALL, null-ALL, and B-ALL. We did not encounter a common-ALL antigen-positive T-ALL subclass. In both adult and childhood ALL, all classes were present, and in about the same frequency as reported by others. In children, common-ALL was the most frequent (66%); in adults, null-ALL (38%). T-ALL was seen both in adults and in children with about the same frequency (27 and 23%, respectively). We found pre-B-ALL only in children. Patients with B-ALL comprised the smallest group in both adult and children (8 and 1.5%, respectively). The application of the OKT antibodies led to recognition of 3 major subclasses of T-ALL: an immature, a common thymocyte...
Cytometry Part B-clinical Cytometry, 2009
BackgroundTo analyze the spectrum of various types and subtypes of acute leukemia.To analyze the spectrum of various types and subtypes of acute leukemia.MethodsTwo thousand five hundred and eleven consecutive new referral cases of acute leukemia (AL) were evaluated based on WHO classification.Two thousand five hundred and eleven consecutive new referral cases of acute leukemia (AL) were evaluated based on WHO classification.ResultsIt included 1,471 cases (58%) of acute lymphoblastic leukemia (ALL), 964 cases (38%) of acute myeloid leukemia (AML), 45 cases (1.8%) of chronic myelogenous leukemia in blast crisis (CMLBC), 37 cases (1.5%) of biphenotypic acute leukemia (BAL), 1 case of Triphenotypic AL, and 2 cases of acute undifferentiated leukemia (AUL). Common subtypes of ALL were B-cell ALL (76%), which comprised of intermediate stage/CALLA positive (73%), early precursor/proBALL (3%). T-cell ALL constituted 24% (351 cases) of ALL. Common subtypes of AML included AMLM2 (27%), AMLM5 (15%), AMLM0 (12%), AMLM1 (12%), APML (11%), and AML t(8;21) (9%). CMLBC was commonly of myeloid blast crisis subtype (40 cases).It included 1,471 cases (58%) of acute lymphoblastic leukemia (ALL), 964 cases (38%) of acute myeloid leukemia (AML), 45 cases (1.8%) of chronic myelogenous leukemia in blast crisis (CMLBC), 37 cases (1.5%) of biphenotypic acute leukemia (BAL), 1 case of Triphenotypic AL, and 2 cases of acute undifferentiated leukemia (AUL). Common subtypes of ALL were B-cell ALL (76%), which comprised of intermediate stage/CALLA positive (73%), early precursor/proBALL (3%). T-cell ALL constituted 24% (351 cases) of ALL. Common subtypes of AML included AMLM2 (27%), AMLM5 (15%), AMLM0 (12%), AMLM1 (12%), APML (11%), and AML t(8;21) (9%). CMLBC was commonly of myeloid blast crisis subtype (40 cases).ConclusionB-cell ALL was the commonest subtype in children and AML in adults. Overall incidence of AML in adults was low (53% only). CD13 was most sensitive and CD117 most specific for determining myeloid lineage. A minimal primary panel of nine antibodies consisting of three myeloid markers (CD13, CD33, and CD117), B-cell lymphoid marker (CD19), T-cell marker (CD7), with CD45, CD10, CD34, and HLADR could assign lineage to 92% of AL. Cytogenetics findings lead to a change in the diagnostic subtype of myeloid malignancy in 38 (1.5%) cases. © 2008 Clinical Cytometry SocietyB-cell ALL was the commonest subtype in children and AML in adults. Overall incidence of AML in adults was low (53% only). CD13 was most sensitive and CD117 most specific for determining myeloid lineage. A minimal primary panel of nine antibodies consisting of three myeloid markers (CD13, CD33, and CD117), B-cell lymphoid marker (CD19), T-cell marker (CD7), with CD45, CD10, CD34, and HLADR could assign lineage to 92% of AL. Cytogenetics findings lead to a change in the diagnostic subtype of myeloid malignancy in 38 (1.5%) cases. © 2008 Clinical Cytometry Society
Leukemia, 1998
This study prospectively analysed the relationships between observed to vary according to the type and number of lymphimmunophenotypic and cytogenetic features of blast cells in oid lineage antigens expressed. 9 The expression of some of 432 acute non-lymphoblastic leukemias (ANLL) at presentation. these antigens also appeared to be related to recurrent cyto-An abnormal karyotype was detected in 232 cases (54%). These genetic abnormalities considered as specific to ANLL subabnormalities were related to immunophenotypic markers as types. 12-16 For instance, CD19 expression was detected in detected using a consensual panel of monoclonal antibodies allowing lineage assignment and investigation of myeloid numerous ANLL with t(8;21) 3,16 and CD2 expression often marker expression on blast cells. In univariate analysis, CD9, appeared related to either inv(16) or t(15;17). 12-16 CD10, CD15, CD34 and TdT expression appeared significantly Here, we report a prospective multicentric study that was associated with chromosomal anomalies. Multivariate analysis designed to better characterise the relationships between cytoidentified CD34 and CD9 expression as independently prediclogic, immunophenotypic and cytogenetic features of ANLL tive of the presence of at least one cytogenetic abnormality at diagnosis. Using a well-defined panel of 24 monoclonal (P Ͻ 10 −4 and P Ͻ 0.03, respectively). Significant associations between immunophenotypic and karyotypic features were antibodies directed against myeloid and lymphoid lineage observed both within individual FAB subgroups and indepenantigens, we observed significant correlation between phenodently from morphological criteria. Specific features were seen typic and cytogenetic ANLL subgroups. The expression of sevin five ANLL entities: M0 or M1/B lineage antigen eral differentiation antigens appeared to be predictive of karypositivity/t(9;22) or del(11)(q23); M2/CD13 ؊ /t(8;21); M4/CD13 ؉ , otypic anomalies. Moreover, several ANLL with a recurrent CD34 ؉ , CD36 ؉ /inv(16); M4 or M5/lack of B lineage cytogenetic abnormality could be associated with a specific antigen/del(11)(q23) or t(9;11). More practically, and although the relationships demonstrated only represent a fraction of immunophenotypic pattern. homogeneous immunophenotypic subgroups, identification of such immunophenotypic features should prompt careful karyotypic examination, eventually using molecular biology analy-Materials and methods sis on non-growing cells.
Pakistan Journal of Medical Sciences, 2021
Objectives: Acute leukaemia is the most common and highly curable childhood malignancy; subtyping and identification of antigens via immunophenotyping helps in treatment plan as well as minimal residual disease monitoring. Methods: This retrospective study was conducted at the Haematology section of the clinical laboratories of Ziauddin University Hospital and The Indus Hospital, Karachi conducted at January 1st, 2012 to December 31st, 2017. The study included 1379 cases of de novo acute leukemia from 2012 to 2017. Among these, 80% were diagnosed by using four color flowcytometry (FACS Calibur), 9% and 11% via immunohistochemistry on bone marrow trephine biopsy samples and morphological examination respectively. Results: The mean age of patients was 7.4 ± 4.3 years while male to female ratio was 1.75:1. Lymphoblastic leukaemia accounted for 77.2% and myeloid leukaemia 21.2%. Amongst lymphoblastic lineage, B-ALL was 80.4% while T-ALL was 19.6%. Among the phenotypic expression of B-AL...
Immunophenotypic Study of Leukaemia Cases
akamaiuniversity.us
This study presents an immunophenotypic study of 739 cases of various types of leukaemia admitted to the Riyadh medical Complex, Riyadh, Saudi Arabia from January 1988 to December 2003. Paterns of observation for morphologically acute leukaemias were observed and classified into sub-types based on French-American-British (FAB) classification.