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. 1980 May;41(5):764–771. doi: 10.1038/bjc.1980.139

Relationship between the pretreatment proliferative activity of marrow blast cells and prognosis of acute lymphoblastic leukaemia of childhood

J H Scarffe, I M Hann, D I K Evans, P Morris Jones, M K Palmer, J S Lilleyman, D Crowther
PMCID: PMC2010298  PMID: 7000111

Abstract

Pretreatment marrow blast cells were studied in 38 boys and 27 girls (aged 1-14) with acute lymphoblastic leukaemia by flow cytometry after staining with propidium iodide.

The percentage of blast cells in the S phase of the cell cycle ranged from 1% to 40% (median 6%). A correlation was found between the percentage of cells in S and the morphological classification of the French American British Cooperative Group (FAB), presence of T or B cell markers, haemoglobin concentration, blast size, bone pain, platelet count, and an inverse correlation with coarse granule and block staining with Periodic-acid-Schiff (PAS).

63 of the 65 children attained complete remission. During the first 24 months of follow up there were fewer relapses (P = 0·054), and deaths (P = 0·004) in those children with 6% or fewer blasts in S phase. The difference was most marked in the first 12 months with 4 relapses out of 33 in the group with 6% or fewer cells in S compared with 13/30 in the group with > 6% cells in S.

In order to investigate the prognostic significance of the pretreatment proliferative studies in greater detail, remission duration was correlated with 17 presenting features. Each feature was correlated individually and then the simultaneous effect of all the features was assessed by stepwise multiple regression.

Only 3 features of the disease at diagnosis were individually correlated with duration of remission. These were% cells in S (P < 0·001), log white cell blood count (WBC) (P < 0·01) and the presence of T- or B-cell surface markers (P < 0·05). However, the multiple regression analysis showed that cell markers were not an independent prognostic feature, whereas the percentage cells in S and log WBC were independently and significantly correlated with duration of first remission (P < 0·001 in each case).

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ascari E., Marini G., Invernizzi R., Ippoliti G., Casirola G., Fontana G., Rizzo S. C. On the usefulness of PAS reaction for the prognosis of acute lymphoblastic leukemia. Haematologica. 1975 Sep;60(3):300–307. [PubMed] [Google Scholar]
  2. Bennett J. M., Catovsky D., Daniel M. T., Flandrin G., Galton D. A., Gralnick H. R., Sultan C. Proposals for the classification of the acute leukaemias. French-American-British (FAB) co-operative group. Br J Haematol. 1976 Aug;33(4):451–458. doi: 10.1111/j.1365-2141.1976.tb03563.x. [DOI] [PubMed] [Google Scholar]
  3. Bennett J. M., Henderson E. S. Lymphoblastic leukaemia. Br Med J. 1969 May 24;2(5655):513–513. doi: 10.1136/bmj.2.5655.513-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Berrebi A., Malaskova V., Oberling F., Mayer S. Application des techniques cytochimiques a 47 cas de leucémies aiguës Modifications cutochimiques au cours de l'évolution. Sem Hop. 1973 Feb 20;49(9):633–643. [PubMed] [Google Scholar]
  5. Crissman H. A., Steinkamp J. A. Rapid, simultaneous measurement of DNA, protein, and cell volume in single cells from large mammalian cell populations. J Cell Biol. 1973 Dec;59(3):766–771. doi: 10.1083/jcb.59.3.766. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Crowther D., Beard M. E., Bateman C. J., Sewell R. L. Factors influencing prognosis in adults with acute myelogenous leukaemia. Br J Cancer. 1975 Oct;32(4):456–464. doi: 10.1038/bjc.1975.247. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Feldges A. J., Aur R. J., Verzosa M. S., Daniels S. Periodic acid-Schiff reaction, a useful index of duration of complete remission in acute childhood lymphocytic leukemia. Acta Haematol. 1974;52(1):8–13. doi: 10.1159/000208214. [DOI] [PubMed] [Google Scholar]
  8. Foadi M. D., Cooper E. H., Hardisty R. M. Proliferative activity of leukaemic cells at various stages of acute leukaemia of childhood. Br J Haematol. 1968 Sep;15(3):269–281. doi: 10.1111/j.1365-2141.1968.tb01538.x. [DOI] [PubMed] [Google Scholar]
  9. Gavosto F., Pileri A., Gabutti V., Masera P. Cell population kinetics in human acute leukaemia. Eur J Cancer. 1967 Nov;3(4):301–307. doi: 10.1016/0014-2964(67)90011-4. [DOI] [PubMed] [Google Scholar]
  10. George S. L., Fernbach D. J., Vietti T. J., Sullivan M. P., Lane D. M., Haggard M. E., Berry D. H., Lonsdale D., Komp D. Factors influencing survival in pediatric acute leukemia. The SWCCSG experience, 1958-1970. Cancer. 1973 Dec;32(6):1542–1553. doi: 10.1002/1097-0142(197312)32:6<1542::aid-cncr2820320634>3.0.co;2-d. [DOI] [PubMed] [Google Scholar]
  11. Hann I. M., Evans D. I., Palmer M. K., Morris-Jones P. J., Haworth C. The prognostic significance of morphological features in childhood acute lymphoblastic leukaemia. Clin Lab Haematol. 1979;1(3):215–226. doi: 10.1111/j.1365-2257.1979.tb00470.x. [DOI] [PubMed] [Google Scholar]
  12. Hart J. S., George S. L., Frei E., 3rd, Bodey G. P., Nickerson R. C., Freireich E. J. Prognotic significance of pretreatment proliferative activity in adult acute leukemia. Cancer. 1977 Apr;39(4):1603–1617. doi: 10.1002/1097-0142(197704)39:4<1603::aid-cncr2820390435>3.0.co;2-8. [DOI] [PubMed] [Google Scholar]
  13. Humphrey G. B., Nesbit M. E., Brunning R. D. Prognostic value of the periodic acid-schiff (PAS) reaction in acute lymphoblastic leukemia. Am J Clin Pathol. 1974 Mar;61(3):393–397. doi: 10.1093/ajcp/61.3.393. [DOI] [PubMed] [Google Scholar]
  14. Kumar S., Carr T. F., Evans D. I., Morris-Jones P., Hann I. M. Prognostic significance of cell surface markers in childhood acute lymphoblastic leukaemia. Clin Lab Haematol. 1979;1(2):121–128. doi: 10.1111/j.1365-2257.1979.tb00459.x. [DOI] [PubMed] [Google Scholar]
  15. Laurie H. C. Duration of remissions in lymphoblastic leukaemia of childhood. Br Med J. 1968 Apr 13;2(5597):95–97. doi: 10.1136/bmj.2.5597.95. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Lilleyman J. S., Mills V., Sugden P. J., Britton J. A. Periodic acid-Schiff reaction and prognosis in lymphoblastic leukaemia. J Clin Pathol. 1979 Feb;32(2):158–161. doi: 10.1136/jcp.32.2.158. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Lonsdale D., Gehan E. A., Fernbach D. J., Sullivan M. P., Lane D. M., Ragab A. H. Interrupted vs. continued maintenance therapy in childhood acute leukemia. Cancer. 1975 Aug;36(2):341–352. doi: 10.1002/1097-0142(197508)36:2<341::aid-cncr2820360208>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]
  18. Masera P., Matera L. In vitro evaluation of growth fraction and other kinetic parameters in human acute leukaemia. Haematologica. 1976 Mar;61(1):9–19. [PubMed] [Google Scholar]
  19. Miller D. R. Prognostic factors in childhood leukemia. J Pediatr. 1975 Oct;87(4):672–676. doi: 10.1016/s0022-3476(75)80889-4. [DOI] [PubMed] [Google Scholar]
  20. Murphy S. B., Aur R. J., Simone J. V., George S., Mauer A. M. Pretreatment cytokinetic studies in 94 children with acute leukemia. Relationship to other variables at diagnosis and to outcome of standard treatment. Blood. 1977 May;49(5):683–691. [PubMed] [Google Scholar]
  21. Murphy S. B., Borella L., Sen L., Mauer A. Lack of correlation of lymphoblast cell size with presence of T-cell markers or with outcome in childhood acute lymphoblastic leukaemia. Br J Haematol. 1975 Sep;31(1):95–101. doi: 10.1111/j.1365-2141.1975.tb00836.x. [DOI] [PubMed] [Google Scholar]
  22. Oster M. W., Margileth D. A., Simon R., Leventhal B. G. Lack of prognostic value of lymphoblast size in acute lymphoblastic leukaemia. Br J Haematol. 1976 May;33(1):131–135. doi: 10.1111/j.1365-2141.1976.tb00979.x. [DOI] [PubMed] [Google Scholar]
  23. Pantazopoulos N., Sinks L. F. Morphological criteria for prognostication of acute lymphoblastic leukaemia. Br J Haematol. 1974 May;27(1):25–30. doi: 10.1111/j.1365-2141.1974.tb06770.x. [DOI] [PubMed] [Google Scholar]
  24. Saunders E. F., Lampkin B. C., Mauer A. M. Variation of proliferative activity in leukemic cell populations of patients with acute leukemia. J Clin Invest. 1967 Aug;46(8):1356–1363. doi: 10.1172/JCI105628. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Sen L., Borella L. Clinical importance of lymphoblasts with T markers in childhood acute leukemia. N Engl J Med. 1975 Apr 17;292(16):828–832. doi: 10.1056/NEJM197504172921604. [DOI] [PubMed] [Google Scholar]
  26. Shaw M. T. Lack of prognostic value of the periodic acid-Schiff reaction and blast cell size in childhood acute lymphocytic leukemia. Am J Hematol. 1977;2(3):237–243. doi: 10.1002/ajh.2830020305. [DOI] [PubMed] [Google Scholar]
  27. Simone J. V., Verzosa M. S., Rudy J. A. Initial features and prognosis in 363 children with acute lymphocytic leukemia. Cancer. 1975 Dec;36(6):2099–2108. doi: 10.1002/cncr.2820360926. [DOI] [PubMed] [Google Scholar]
  28. Tsukimoto I., Wong K. Y., Lampkin B. C. Surface markers and prognostic factors in acute lymphoblastic leukemia. N Engl J Med. 1976 Jan 29;294(5):245–248. doi: 10.1056/NEJM197601292940503. [DOI] [PubMed] [Google Scholar]
  29. Vowels M. R., Willoughby M. L. Cyclic chemotherapy in acute lymphoblastic leukaemia of childhood: 5-year survivals. Arch Dis Child. 1973 Jun;48(6):436–440. doi: 10.1136/adc.48.6.436. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Zippin C., Cutler S. J., Lum D. Time trends in survival in acute lymphocytic leukemia. J Natl Cancer Inst. 1975 Mar;54(3):581–586. [PubMed] [Google Scholar]

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