Prognostic significance of cell surface phenotype in adult acute lymphoblastic leukaemia

Lister, T. A.; Roberts, Melanie; Brearley, Roger; Woodruff, Roger; Greaves, MF

doi:10.1007/bf00200209

Cited by 35 publications

(9 citation statements)

References 18 publications

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“…Further antigenic heterogeneity is also demonstrable within the subgroups; thus, approximately 10% ofT-ALL have a weak but unequivocal expression of the gpl00 cALL antigen (above data; see also Roberts et al, 1978; but lack the HLA-DR/Ia antigen and otherwise have a thymic subset phenotype. As reported elsewhere (Greaves et al, 1979), one third of cALL have a 'pre-B' phenotype with cytoplasmic p chains. Patients in our series with other minor variant phenotypes have also been described, e.g.…”

Section: Heterogeneity Of a L L And Its 'Biological' Classificationsupporting

confidence: 69%

“…A minor subtype of T-ALL that expresses the cALL antigen but no p28,33 (Ia-like/ HLA-DR) antigen and has variable reactivity with T cell markers, was also identified (see also Roberts ei al, 1978; Janossy et a / , 1980). Elsewhere we have reported that approximately one third of the cALL subclass have a 'pre-B' phenotype (Greaves et a / , 1979) as defined by the presence of cytoplasmic p (IgM) heavy chains (Vogler et a / , 1978;Brouet et af, 1979). As this subset appeared similar to the remaining two-thirds of the cALL group with respect to clinical and haematological features, cALL is treated as a single group in this report.…”

Section: Tire All Sul~~qroirys Atid Fentrrres Observed At Preseritatiotrmentioning

confidence: 99%

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Immunologically Defined Subclasses of Acute Lymphoblastic Leukaemia in Children: their Relationship to Presentation Features and Prognosis

et al. 1981

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Leukaemic cells from 542 patients under 21 years of age with a diagnosis of acute lymphoblastic leukaemia (ALL) were typed with immunological cell surface markers between June 1975 and December 1979; 379 of these patients entered into the trials up until December 1978 have been followed for more than 1 year. They were divided into four subgroups: common (c) ALL, T (thymic) ALL, 'null' (or 'unclassified') ALL and a rare lymphoma/leukaemia type B-ALL. A T-cell phenotype was found more frequently in boys and was usually but not invariably associated with a high white cell count at presentation. A mediastinal thymic mass was present in 53% of T-ALL patients but was not observed in any unequivocal not-T ALL. Clinical prognosis differed substantially between the three major phenotypic classes, remission induction rate and remission duration being lowest in T-ALL, better in 'null' ALL, and highest in cALL (P trend less than 0 . 0001; P = 0 . 0002 for comparison of cALL versus T-ALL). There was a much higher incidence of CNS involvement in the T-ALL group than in the cALL group or 'null' All group and although this was strongly correlated with WBC count it was also significantly associated with T-ALL independent of WBC count. Overall in this series and also within the major cALL subclass there is a strong correlation between high WBC count and poor clinical response (remission induction and duration). When the three major immunological subclasses are adjusted for WBC count the prognostic correlation of antigenic phenotype is reduced and statistically insignificant. It is suggested that immunological (and enzymatic) phenotype of ALL subclasses may not be an independent correlate of prognosis but nevertheless is linked to other cell differentiation features, especially growth rate and sites of clonal expansion (e.g. marrow versus thymus), which critically influence the size of the clonogenic leukaemic population and its associated evolutionary status with the respect to drug resistant mutants at the time of diagnosis and introduction of therapy.

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Section: Heterogeneity Of a L L And Its 'Biological' Classificationsupporting

confidence: 69%

Section: Tire All Sul~~qroirys Atid Fentrrres Observed At Preseritatiotrmentioning

confidence: 99%

Immunologically Defined Subclasses of Acute Lymphoblastic Leukaemia in Children: their Relationship to Presentation Features and Prognosis

et al. 1981

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“…This finding is remarkable, since up to now patients with T-ALL, who frequently have a high initial leukocyte count, a mediastinal tumor, or CNS involvement, have had a poor prognosis. The worst prognosis, in keeping with findings from another study (Lister et al 1979), was for patients with null-AL, who had a median remission duration of 13 months. Of the patients with c-ALL, 44% were disease-free at the evaluation date.…”

Section: Prognostic Factorssupporting

confidence: 51%

Risk Groups in a Multicenter Pilot Study for Treatment of Acute Lymphoblastic and Acute Undifferentiated Leukemia in Adults

Hoelzer¹,

Thiel²,

Löffler³

et al. 1985

Modern Trends in Human Leukemia VI New Results in Clinical and Biological Research Including Pediatric Oncology

106

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“…However, the addition of high-dose ara-C does appear to have improved the prognosis of patients with 'poor risk' prognostic factors, i.e. those with a high blast cell count (Barnett et al, 1986;Amadori et al, 1980;Baccarani et al, 1982;Gingrich et al, 1985;Lazzarino et al, 1982;Marcus et al, 1986;Clarkson et al, 1985) and those with T-cell ALL (Bitran, 1978;Baccarani et al, 1983;Lister et al, 1979). These results are consistent with the findings of two large studies in which the use of intensive remission induction and consolidation therapy has resulted in patients with T-ALL having a better prognosis than those with C-ALL (Clarkson et al, 1985;Hoelzer et al, 1988).…”

Section: Discussionmentioning

confidence: 99%

High dose cytosine arabinoside in the initial treatment of adults with acute lymphoblastic leukaemia

Rohatiner

Bassan²,

Battista³

et al. 1990

Br J Cancer

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In a study conducted at St Bartholomew's Hospital between 1972 and 1982, using moderately intensive therapy (OPAL/HEAV'D), a low blast count at presentation (less than 10 x 10(9) 1(-1)) and common ALL (C-ALL) phenotype correlated favourably with duration of remission. Fifty-four patients (age range 15-57, median 32) subsequently received a modification of the previous treatment programme which included high-dose ara-C 2 g m-2 b.d. for 6 days as cycle 3 (OPAL + HD ARA-C). CR was achieved in 36/54 (67%) patients, response correlating favourably with younger age (15-30 years vs 31-57 years, P = 0.02). Three patients died in CR. Overall, there was no difference in survival or remission duration between patients who received high dose ara-C and those in the control group. However, in contrast to the early results, there was a reversal in the relevance of the prognostic factors with a trend in favour of high blast count (greater than 10 x 10(9) 1(-1)) and T-cell phenotype in terms of remission duration. Moreover, comparison of duration of remission for the previously defined prognostic groups according to therapy suggests that the prognosis of patients with 'high risk' disease (T, B, null ALL or high blast count) is improved with more intensive therapy. In contrast, those with 'low risk' disease (C-ALL and low blast count) have a better prognosis with less intensive therapy. These observations confirm those of others and allow for individualization of therapy on the basis of pre-treatment variables.

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Prognostic significance of cell surface phenotype in adult acute lymphoblastic leukaemia

Cited by 35 publications

References 18 publications

Immunologically Defined Subclasses of Acute Lymphoblastic Leukaemia in Children: their Relationship to Presentation Features and Prognosis

Immunologically Defined Subclasses of Acute Lymphoblastic Leukaemia in Children: their Relationship to Presentation Features and Prognosis

Risk Groups in a Multicenter Pilot Study for Treatment of Acute Lymphoblastic and Acute Undifferentiated Leukemia in Adults

High dose cytosine arabinoside in the initial treatment of adults with acute lymphoblastic leukaemia

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