Leukemia versus lymphoma in children: A worthless question?

Bernard, Alain; Boumsell, Laurence; Patte, Catherine; Lemerie, Jean

doi:10.1002/mpo.2950140309

Cited by 14 publications

(2 citation statements)

References 81 publications

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“…Previous studies compared MRD results obtained by FC and PCR in ALL, mostly in B-lineage [44][45][46][47][48]; some of them included very few patients [2][3][4][5][6][7][8][9][10][11][12][13][14][15] with T-cell ALL [44][45][46][47]. In our study of T-LLy involving BM at presentation, the positive/negative concordance between the two methods using a threshold of !0.01% was 67%.…”

Section: Discussionmentioning

confidence: 94%

“…T-LLy and T-cell acute lymphoblastic leukemia (T-ALL) are often considered to be part of a spectrum of a single disease [1]. The malignant cells in T-ALL and T-LLy are morphologically indistinguishable, and the immunophenotype and genetic abnormalities are similar [1,[4][5][6][7]. However, differences in predominant sites of involvement, biological behavior [4,[8][9][10] and distinct gene expression profile [9] have been observed.…”

Section: Introductionmentioning

confidence: 99%

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Bone marrow minimal disseminated disease (MDD) and minimal residual disease (MRD) in childhood T‐cell lymphoblastic lymphoma stage III, detected by flow cytometry (FC) and real‐time quantitative polymerase chain reaction (RQ‐PCR)

Stark

Avigad

Luria

et al. 2008

Pediatric Blood & Cancer

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BackgroundDespite overlapping features of T‐cell lymphoblastic lymphoma (T‐LLy) and T‐cell acute lymphoblastic leukemia (T‐ALL), which respond favorably to T‐ALL treatment, clinical and biological differences exist. We retrospectively assessed the prevalence of submicroscopic bone marrow (BM) minimal disseminated disease (MDD) at diagnosis and the early response to treatment (minimal residual disease—MRD) and their prognostic significance in 17 children with stage III T‐LLy treated according to Berlin‐Frankfurt‐Munster (BFM) non‐Hodgkin lymphoma protocols.ProcedureFour‐color flow cytometry (FC) was used for lymphoma associated immunophenotype and real‐time quantitative polymerase chain reaction (RQ‐PCR) for T‐cell receptor (TCR β/δ/γ) gene rearrangements with at least 0.01% sensitivity.ResultsTwo markers per patient were identified in all cases using FC and in 80% using RQ‐PCR. BM MDD at diagnosis of ≥0.01% was detected by FC and RQ‐PCR in 88% and 80% of patients, respectively, and by at least one of the methods in all patients. A significant correlation was achieved between the methods by Pearson correlation analysis (P = 0.004). MRD levels significantly decreased to very low levels on day 33 in 9 out of 10 patients studied. The only patient that remained positive relapsed.ConclusionsMDD was prevalent in stage III T‐LLy, for which we could not prove a prognostic significance in the context of ALL‐like treatment. This study shows that both FC and RQ‐PCR methods are efficient for MDD and MRD analyses in T‐LLy. Pediatr Blood Cancer 2009;52:20–25. © 2008 Wiley‐Liss, Inc.

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Bone marrow minimal disseminated disease (MDD) and minimal residual disease (MRD) in childhood T‐cell lymphoblastic lymphoma stage III, detected by flow cytometry (FC) and real‐time quantitative polymerase chain reaction (RQ‐PCR)

Stark

Avigad

Luria

et al. 2008

Pediatric Blood & Cancer

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Lymphomatous presentation of childhood acute lymphoblastic leukemia. A subgroup at high risk of early treatment failure

Steinherz

Siegel

Bleyer

et al. 1991

Cancer

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Multivariate analyses of the clinical course of 1537 children with acute lymphoblastic leukemia (ALL) identified a subgroup which experienced short remission duration and a high incidence of extramedullary relapse. The patients differed from other ALL patients by the presence at diagnosis of two or more of a constellation of clinical and laboratory features: organomegaly or mass disease, E-rosette positivity, hemoglobin level greater than 10 g/dl, leukocyte count greater than 50,000/microliters, male predominance, and older age. This type of presentation of ALL is referred to as the "lymphoma syndrome" (LS) since such patients exhibit a pattern of several clinical and laboratory features which were observed repeatedly but in differing combinations, and some of which clinically resemble lymphoma. A subsequent database from 2231 patients was analyzed. Patients with a mediastinal mass, massive splenomegaly, or massive adenopathy, alone or in combination, had a worse outcome when the patient also had either leukocytosis, E-rosette-positive lymphoblasts, or a normal or near normal hemoglobin (Hb) level at diagnosis. Similarly, the above three laboratory features alone or in combination did not predict less than 40% disease-free survival (DFS) unless they were accompanied by at least one of the clinical features of mass disease. When at least one clinical feature and at least one laboratory feature were present, the overall DFS was 36% 6 years after diagnosis versus 64% for all other patients. The association of these features with poor prognosis remained significant after adjusting for the level of leukocyte count at diagnosis, age at diagnosis, and sex of the patients. Patients with this recurrent syndrome of features do not represent a homogeneous biologic entity but they constitute a subgroup of patients with ALL having a high risk of treatment failure using current therapies, including failure to achieve remission, early relapse, and increased frequency of relapse in extramedullary sites. They deserve early recognition at diagnosis and selection of treatment strategies appropriate for very high risk ALL.

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Malignant lymphomas in children in the Netherlands in the period 1973‐1985: Incidence in relation to leukemia: A report from the dutch childhood leukemia study group

Coebergh

Berg

Kamps

et al. 1991

Med. Pediatr. Oncol.

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A retrospective study was done of the incidence of non-Hodgkin's lymphoma (NHL) in children in the Netherlands in the period 1973-85 in relation to that of acute lymphoblastic leukemia (ALL). Complete ascertainment of cases was most likely achieved through the network of cooperating pediatricians of the Dutch Childhood Leukemia Study Group (DCLSG). The incidence of NHL remained constant at 0.75 per 10(5) children per year; the boy/girl ratio was 2.5. In +/- 25% of cases the disease was localized at diagnosis. Of children with NHL who were not listed in the DCLSG leukemia register, 19% had greater than or equal to 25% lymphoblasts in the bone marrow at diagnosis, representing an overlap with ALL of +/- 5%. In 1% of the children with NHL an immuno-deficiency disorder preceded the diagnosis. The incidence of Hodgkin's disease (HD) was 0.3 per 10(5) children per year, with some fluctuation over time, the peak being 0.7 in 1983. The boy/girl ratio was 2.7. Age-specific incidence rates, clinical features of NHL and HD, as well as the ALL to NHL ratio corresponded with those in other European countries and for white children in the USA.

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Leukemia versus lymphoma in children: A worthless question?

Cited by 14 publications

References 81 publications

Bone marrow minimal disseminated disease (MDD) and minimal residual disease (MRD) in childhood T‐cell lymphoblastic lymphoma stage III, detected by flow cytometry (FC) and real‐time quantitative polymerase chain reaction (RQ‐PCR)

Bone marrow minimal disseminated disease (MDD) and minimal residual disease (MRD) in childhood T‐cell lymphoblastic lymphoma stage III, detected by flow cytometry (FC) and real‐time quantitative polymerase chain reaction (RQ‐PCR)

Lymphomatous presentation of childhood acute lymphoblastic leukemia. A subgroup at high risk of early treatment failure

Malignant lymphomas in children in the Netherlands in the period 1973‐1985: Incidence in relation to leukemia: A report from the dutch childhood leukemia study group

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