Acute lymphoblastic leukemia with aleukemic prodrome: preleukemic dynamics and possible mechanisms of immunosurveillance

Zimmermannová, Olga; Žaliová, Markéta; Moorman, Anthony V.; Al-Shehhi, Halima; Froňková, Eva; Zemanová, Zuzana; Kalina, Tomáš; Vora, Ajay; Starý, Jan; Trka, Jan; Hrušák, Ondřej; Zuna, Jan

doi:10.3324/haematol.2016.161380

Cited by 6 publications

(4 citation statements)

References 15 publications

(11 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, ninety-two days before diagnosis, all analysed cells had deletion of non-translocated ETV6 and 14q24 alleles (167/167 and 5/5 cells, respectively). Other additional genetic aberrations were then identified at the time of diagnosis [15].…”

Section: Discussionmentioning

confidence: 99%

Acute Lymphoblastic Leukemia cured without treatment – is That So?

Figueiredo,

Maia-Moço,

Maia

et al. 2023

BJCR

View full text Add to dashboard Cite

Spontaneous remission of acute lymphoblastic leukemia is an extremely rare phenomenon. It usually occurs in an aleukemic prodromic setting associated with cytopenias and fever. Nonetheless, this remission status, as far as we know, is always transient, the longest one de-scribed lasting one year. In this case report, we present a 25-months year-old boy with de novo bruises. His complete blood count displayed thrombocytopenia and leukopenia, and biochemistry analysis an increased lactate dehydrogenase. Although bone marrow aspirate was unremarkable, trephine biopsy was suggestive of B-cell acute lymphoblastic leukemia. Within three months, however, he showed a spontaneous clinical and analytical recovery. A repeated biopsy performed two years after was also completely normal. At the time of the writing of this paper, seven years later, the child remains free of progression. It might be the longest spontaneous remission ever described. Opposingly, some histology reports added a differential diagnosis - that the 24.49% immature B-cell infiltrate could, as well, resemble B-hematogones. Hence, we herein try to unveil the mechanism under this particular phenomenon. More efforts should be directed towards research about pre-acute lymphoblastic leukemia and spontaneous remission, so that pediatricians and pathologists can be more comfortable with these rare, but very challenging, situations.

show abstract

Section: Discussionmentioning

confidence: 99%

Acute Lymphoblastic Leukemia cured without treatment – is That So?

Figueiredo,

Maia-Moço,

Maia

et al. 2023

BJCR

View full text Add to dashboard Cite

show abstract

“…However, there are still patients who can not be effectively relieved even if they are treated. As a result, it is particularly vital to find new anti-leukemia drugs with low toxicity (15,16).…”

Section: Discussionmentioning

confidence: 99%

GEM on proliferation and apoptosis of childhood AL cells through inhibiting c‑myc expression by upregulating miR‑125a‑3p

Xing

Yin

et al. 2020

Oncol Lett

View full text Add to dashboard Cite

Effect of gemcitabine (GEM) on proliferation and apoptosis of childhood acute leukemia (AL) cells and the mechanism of action were investigated. Bone marrow and peripheral blood of 18 newly diagnosed children with childhood AL admitted to Yidu Central Hospital of Weifang were selected, and the miR-125a-3p level in peripheral blood of healthy children and children with AL was detected by quantitative reverse transcription-polymerase chain reaction (qRT-PCR). Leukemia cells from the bone marrow of children with AL were primarily cultured and purified to observe the morphology. miR-125a-3p mimic was transfected into childhood AL cells. The cells were randomly divided into three groups: control group, GEM group and GEM + miR-125a-3p mimic group. 5-ethynyl-2'-deoxyuridine (EdU) staining assay was chosen to detect the proliferation of childhood AL cells in each group. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining assay was adopted to determine apoptosis of childhood AL cells. The protein level of c-myc was measured via western blotting. Compared with that in the healthy children, the level of miR-125a-3p in the peripheral blood of children with AL was remarkably decreased. Compared with those in the control group, GEM inhibited proliferation and promoted apoptosis of childhood AL cells, and impeded the protein expression of c-myc in these cells. Compared with those in the GEM group, GEM + miR-125a-3p mimic notably reduced the proliferation and enhanced apoptosis of cells, and the protein expression of c-myc in cells was overtly reduced. The level of miR-125a-3p in peripheral blood of children with AL is obviously decreased. It is suggested in this study that GEM can inhibit the proliferation and promote apoptosis of childhood AL cells, and the mechanism may be related to upregulated miR-125a-3p inhibiting the expression of c-myc.

show abstract

“…An important limitation of this report is the lack of bone marrow biopsy data prior to the initiation of leukemia-specific treatment and minimal residual disease studies following SR. More sensitive tests would have been helpful to better characterize the disease and the degree of SR. The concept that in cases of pre-ALL an overt malignant condition may exist initially undetected but potentially traceable by molecular tests, is supported by numerous retrospective analyses ( 16 , 19 – 21 ), and by a case report of a patient who received allogenic stem cell transplantation for suspected severe aplastic anemia and later developed ALL originating from hosts cells ( 22 ). A review of the literature did not reveal any specific patterns of cytogenetic abnormalities in SR or pre-ALL.…”

Section: Discussionmentioning

confidence: 99%

“…The described cytogenetic abnormalities included complex karyotypes, numeric alterations as well as translocation and derivations in SR and in pre-ALL. A recently published study did not report classical cytogenetic studies but retrospectively analyzed specimens of the aleukemic phase of 8 cases of pre-ALL, and detected ETV6-RUNX1 fusions in bone marrow cells that were also present during overt ALL ( 21 ). The study suggested that in pre-ALL established (pre-)leukemic clones are temporarily controlled by the immune system until eventually dominant subclones are selected and induce clinical ALL ( 21 ).…”

Section: Discussionmentioning

confidence: 99%

Spontaneous remission of acute lymphoblastic leukemia: A case report

2017

View full text Add to dashboard Cite

Spontaneous remission (SR) in acute lymphoblastic leukemia (ALL) is a rare phenomenon, but the disease course and its underlying processes are of basic and clinical interest. Herein is reported the case of a pregnant, 31-year-old patient who developed ALL, followed by septic shock and SR of ALL. Information is summarized from earlier case reports and incidences of SR in ALL, to identify common patterns. Furthermore, the phenomenon of SR is compared with another disease variant of ALL, termed prodromal or preceding-ALL (pre-ALL). SR and the aleukemic phase in pre-ALL are associated with fever and/or sepsis and have similar kinetics and epidemiology. Therefore, pre-ALL not only closely resembles SR in ALL, but both conditions may represent a single disease entity. Production of pro-inflammatory cytokines and immune cell effects may induce temporary remission of ALL and the suppression of hematopoiesis. In contrast to SR in other types of cancer, all documented cases of SR in ALL were only transient. However, the disease can still be effectively treated with standard ALL therapies following relapse.

show abstract

Acute lymphoblastic leukemia with aleukemic prodrome: preleukemic dynamics and possible mechanisms of immunosurveillance

Cited by 6 publications

References 15 publications

Acute Lymphoblastic Leukemia cured without treatment – is That So?

Acute Lymphoblastic Leukemia cured without treatment – is That So?

GEM on proliferation and apoptosis of childhood AL cells through inhibiting c‑myc expression by upregulating miR‑125a‑3p

Spontaneous remission of acute lymphoblastic leukemia: A case report

Contact Info

Product

Resources

About