Terminal deoxynucleotidyl transferase activity in acute leukemia: A study of 100 cases comparing an immunoperoxidase (PAP) vs immunofluorescent method

Kaplan

Štolc

et al. 1991

Self Cite

The routine use of panels of monoclonal antibodies has been complementary to the French-American-British (FAB) leukemia classification, and has unmasked the occurrence of mixed acute leukemia (myeloid-lymphoid). It is widely accepted that children with Down's syndrome (DS) have a high incidence of acute leukemia. There is an extensive body of literature emphasizing the cytogenetic findings in these children. However, information as to the immunophenotype is often limited to the lymphoid surface determinants. The authors report two children with DS whose leukemic blasts were studied with a panel of 17 monoclonal antibodies (myeloid, lymphoid, and megakaryocytic) by flow cytometric examination and were classified as biphenotypic acute leukemia. The blast population coexpressed myeloid and T-cell surface markers. The lymphoid origin was ruled out on the basis of negative terminal deoxynucleotidyl transferase and molecular analysis demonstrating germline configuration for the JH and beta TCR genes.

Section: Methodsmentioning

confidence: 99%

Down's syndrome and mixed acute leukemia in infants

Kaplan

Štolc

et al. 1991

Self Cite

Immunophenotyping in the classification of acute leukemia in adults. Interpretation of multiple lineage reactivity

Kaplan

Štolc

et al. 1989

Self Cite

Fifty-nine adult patients with acute leukemia were classified using a combination of the French-American-British (FAB) criteria and characterization by immunophenotyping using flow cytometric study. The authors identified 51 patients with acute myeloblastic leukemia and eight with acute lymphoblastic leukemia. This procedure permitted lineage assignment in leukemias that otherwise might have been unclassifiable. In addition, the authors demonstrated that the leukemic blasts of 29% of patients with myeloblastic disease exhibited one or more T-cell antigens on their surface. The use of immunophenotyping has greatly enhanced the authors' ability to correctly identify the lineage of acute leukemias. The data, however, must be interpreted with caution with respect to diagnosing acute mixed lineage leukemias and must be integrated with the morphologic and cytochemical evaluation of traditional classification schemes. The possible significance of T-cell markers in myeloblastic leukemia is discussed. Cancer 63:1520-1527, 1989. CUTE LEUKEMIAS are classified according to their A stem cell of origin and to a subset within that cell lineage. This assignment is based upon morphologic and cytochemical characteristics according to the French-American-British (FAB) classification system. ' This system of standardization has been useful because it has allowed for more reliable comparison of data generated from different centers and because the natural course and the response to treatment of the leukemia may be predicted on the basis of lineage and, to a lesser extent, on the basis of subtype.'" The development and commercial availability of monoclonal antibodies to surface antigens on leukemic cells, together with advances in flow cytometric technology , have dramatically improved our ability to characterize leukemic cells with respect to cell lineage.5-" The widespread use of selected monoclonal antibodies (leu

Three infants with acute megakaryoblastic leukemia simulating metastatic tumor

Taylor

Krause

1989

Self Cite

The diagnosis of acute megakaryoblastic leukemia (AMKL) (M7, French-American-British [FAB] classification) has rarely been made in children due, in part, to its pleomorphic morphology and ability to mimic other malignancies common in the pediatric age group. Three infants are described who had thrombocytopenia and the classical criteria of metastatic solid tumor in the bone marrow: patchy infiltration by cohesive clusters of cells with high nuclear cytoplasmic ratio and myelofibrosis in the bone marrow biopsy infiltrated area. This finding prompted clinical evaluation for solid tumor. The megakaryocytic lineage was ascertained by immunocytochemical studies and/or electron microscopic examinations of the bone marrow aspirates. The blasts in all three patients showed cytogenetic abnormalities that also were demonstrated by quantitative DNA analysis. None of the infants had Down's syndrome. Two of the patients are alive; one is off of therapy and the other is in remission. The third patient was transferred to another institution and lost to follow-up. Two children had wheezing that disappeared in remission. It is proposed that the clinical symptoms may be due to a substance produced, stored, or released by the leukemic cells.