Subscribe to RSS

DOI: 10.4103/2278-330X.155696
Prognostic significance of cell surface phenotype in acute lymphoblastic leukemia
Source of Support: Nill.
Abstract
Context: To find out the phenotypic character of lymphoblasts of acute lymphoblastic leukemia (ALL) patients in our study cohort and their possible effect on the prognosis. Aims: To investigate the phenotype in ALL in our demographic population and to prognosticate various upfront current protocols employed in our hospital. Settings and Design: The study spanned over a period of 4 years with retrospective and prospective data of January 2008 through December 2011. Materials and Methods: 159 patients of all age groups were enrolled for the study, of which flow cytometry was done in 144 patients. Statistical Analysis Used: Analysis was done using the variables on SPSS (statistical package for social sciences) software on computer. Survival curves were estimated by method of Kaplan-Meir. Results: Majority of the patients were of B-cell (68.1%) and 30.6% patients were of T-cell lineage. Of these, 80.6% patients were having cALLa positivity. Complete remission (CR) was achieved in 59.1%, 16.4% relapsed, and 20.1% patients died. Conclusions: Phenotyping has become an important and integral part of diagnosis, classification, management and prognosticating in ALL. B-cell has been found to have a better survival over T-cell lymphoblastic leukemia. cALLa antigen positivity has good impact in achieving CR in only B-cell lineage, myeloid coexpression has no significant effect on the outcome. BFM (Berlin-Frankfurt-Münster) based protocols though showed a higher CR and survival vis-a-vis UKALL-XII. However, patients enrolled in former group being of low risk category and lesser in numbers cannot be compared statistically with a fair degree of confidence.
Key words
Acute lymphoblastic leukemia - flow cytometry - immunophenotype - India - Kashmir - leukemia - phenotype - prognosisPublication History
Article published online:
31 December 2020
© 2015. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
-
References
- 1 Dores GM, Devesa SS, Curtis RE, Linet MS, Morton LM. Acute leukemia incidence and patient survival among children and adults in the United States, 2001-2007. Blood 2012;119:34-43.
- 2 Pui CH, Evans WE. Acute lumphoblastic leukemia. N. Engl J Med 1998:339:605-15.
- 3 Channa J, Shamsi T, Hashmi K. Role of immunophenotyping in diagnosis of acute leukemia. J Coll Physicians Surg Pak 2000;10:158-60.
- 4 Pui CH. Childhood leukemias. N Engl J Med 1995:332:1618-30.
- 5 Sobol RE, Mick R, Royston I, Davey FR, Ellison RR, Newman R, et al. Clinical importance of myeloid antigen expression in adult acute lymphoblastic leukemia. N Engl J Med 1987;316:1111-7.
- 6 Crist W, Pullen J, Boyett J, Falleta J, van Eys J, Borowitz M, et al. Acute lymphoid leukemia in adolescents: Clinical and biologic features predict a poor prognosis. A Pediatric Oncology Group study. J Clin Oncol 1988;6:34-43.
- 7 Bradstock KF, Kirk J, Grimsley PG, Kabral A, Hughes WG. Unusual immunophenotypes in acute leukaemias: Incidence and clinical correlations. Br J Haematol 1989;72:512-8.
- 8 Childs CC, Hirsch-Ginsberg C, Walters RS, Anderson BS, Reuben J, Trujillo JM, et al. Myeloid surface antigen-positive acute lymphoblastic leukemia (My + ALL): Immunophenotypic, ultrastructural, cytogenetic and molecular characteristics. Leukemia 1989;11:777-83.
- 9 Ludwig WD, Bartram CR, Harbott J, Koller U, Haas OA, Hansen-Hagge T, et al. Phenotypic and genotypic heterogeneity in infant acute leukemia I. acute lymphoblastic leukemia. Leukemia 1989;6:431-9.
- 10 Guyotat D, Campos L, Shi ZH, Charrin C, Treille D, Magaud JP, et al. Myeloid surface antigen expression in adult acute lymphoblastic leukemia. Leukemia 1990;9:664-6.
- 11 Pui CH, Behm FG, Singh B, Rivera GK, Schell MJ, Roberts WM, et al. Myeloid-associated antigen expression lacks prognostic value in childhood acute lymphoblastic leukemia treated with intensive multiagent chemotherapy. Blood 1990;75:198-202.
- 12 Wiersma SR, Ortega J, Sobel E, Weinberg KI. Clinical importance of myeloid-antigen expression in acute lymphoblastic leukemia of childhood. N Engl J Med 1991;324:800-8.
- 13 Pui CH, Behm FG, Crist WM. Clinical and biologic relevance of immunologic marker studies in childhood acute lymphoblastic leukemia. Blood 1993;82:343-62.
- 14 Greaves MF, Brown C, Rapson NT, Lister A. Antisera to acute lymphoblastic leukemia cells. Clin Immunol Immunopathol 1975;4:67-84.
- 15 Hoelzer D, Thiel E, Loffler H, Buchner T, Ganser A, Heil G, et al. Prognostic factors in a multicenter study for treatment of acute lymphoblastic leukemia in adults. Blood 1988;71:123-31.
- 16 Hoelzer D. High-dose chemotherapy in adult acute lymphoblastic leukemia. Semin Hematol 1991;28:84-9.
- 17 Berman E, Weiss M, Kempin S, Gee T, Bertino J, Clarkson B. Intensive therapy for adult acute lymphoblastic leukemia. Semin Hematol 1991;28:72-5.
- 18 Linker CA, Levitt LJ, O′Donnell M, Forman SJ, Ries CA. Treatment of adult acute lymphoblastic leukemia with intensive cyclical chemotherapy: A follow-up report. Blood 1991;78:2814-22.
- 19 Blume KG, Forman SJ, Snyder DS, Nademanee AP, O′Donne1 MR, Fahey JL, et al. Allogeneic bone marrow transplantation for acute lymphoblastic leukemia during first complete remission. Transplantation 1987;43:389-92.
- 20 Weisdorf DJ, McGlave PB, Ramsay NK, Miller WJ, Nesbit ME, Woods WG, et al. Allogeneic bone marrow transplantation for acute leukemia: Comparative outcomes for adults and children. Br J Haematol 1988;69:351-8.
- 21 Tsukimoto I, Wong HY, Lampkin BC. Surface markers and prognostic factors in acute lymphoblastic leukemia. N Engl J Med 1976;294:245-8.
- 22 Chessells IM, Hardisty RM, Rapson NT, Greaves MF. Acute lymphoblastic leukaemia in children: Classification and prognosis. Lancet 1977;2:1307-9.
- 23 Borella L, Sen L, Dow LW, Casper IT. Cell differentiation antigens versus tumor-related antigens in childhood acute lymphoblastic leukemia (ALL). Clinical significance of leukemia markers. In: Thierfelder S, Rod H, Thiel E, editors. Immunological Diagnosis of Leukemias and Lymphomas. Vol. 20. Berlin: Springer-Verlag; 1977. p. 77 -86.