Abstract
Early detection of testicular leukaemia and the identification of residual leukaemic cells in treated patients are important aims in the management of males with acute lymphoblastic leukaemia (ALL). In most cases of ALL ( greater than 95%) the blast cells express terminal deoxynucleotidyl transferase (TdT), a nuclear enzyme. We have therefore standardized the immuno-fluorescence and -peroxidase techniques (using anti-Tdt antibodies) for identifying TdT cells in the normal thymus, as well as in samples of testis with heavy leukaemic infiltrates (positive controls). TdT cells can be identified in formalin (but not in Bouin's or Carnoy's) fixed paraffin-embedded tissues, and the preservation of morphological details is excellent. The method is nevertheless difficult to standardize and also requires the use of deoxyribonuclease (DNase) for the digestion of sections. However, in frozen tissue sections, stronger staining of TdT cells was found, even without DNase treatment. Good morphology was preserved when cut sections were fixed immediately in the cryostat. In the second part of the study 15 samples from treated boys were analysed to see whether the technique is suitable to identify residual minimal leukaemic infiltrates. In 5 patients scanty disseminated TdT cells were detected, and in 2 patients small clumps of TdT cells were seen. The results indicate that the immunohistological identification of TdT ALL blasts may be the method of choice.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bollum F. J. Terminal deoxynucleotidyl transferase as a hematopoietic cell marker. Blood. 1979 Dec;54(6):1203–1215. [PubMed] [Google Scholar]
- Bradstock K. F., Papageorgiou E. S., Janossy G. Diagnosis of meningeal involvement in patients with acute lymphoblastic leukemia: immunofluorescence for terminal transferase. Cancer. 1981 May 15;47(10):2478–2481. doi: 10.1002/1097-0142(19810515)47:10<2478::aid-cncr2820471027>3.0.co;2-a. [DOI] [PubMed] [Google Scholar]
- Burns J., Hambridge M., Taylor C. R. Intracellular immunoglobulins. A comparative study on three standard tissue processing methods using horseradish peroxidase and fluorochrome conjugates. J Clin Pathol. 1974 Jul;27(7):548–557. doi: 10.1136/jcp.27.7.548. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Janossy G., Bollum F. J., Bradstock K. F., Ashley J. Cellular phenotypes of normal and leukemic hemopoietic cells determined by analysis with selected antibody combinations. Blood. 1980 Sep;56(3):430–441. [PubMed] [Google Scholar]
- Janossy G., Woodruff R. K., Pippard M. J., Prentice G., Hoffbrand A. V., Paxton A., Lister T. A., Bunch C., Greaves M. F. Relation of "lymphoid" phenotype and response to chemotherapy incorporating vincristine-prednisolone in the acute phase of Ph1 positive leukemia. Cancer. 1979 Feb;43(2):426–434. doi: 10.1002/1097-0142(197902)43:2<426::aid-cncr2820430204>3.0.co;2-h. [DOI] [PubMed] [Google Scholar]
- Kuo T. T., Tschang T. P., Chu J. Y. Testicular relapse in childhood acute lymphocytic leukemia during bone marrow remission. Cancer. 1976 Dec;38(6):2604–2612. doi: 10.1002/1097-0142(197612)38:6<2604::aid-cncr2820380655>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
- Lendon M., Hann I. M., Palmer M. K., Shalet S. M., Jones P. H. Testicular histology after combination chemotherapy in childhood for acute lymphoblastic leukaemia. Lancet. 1978 Aug 26;2(8087):439–441. doi: 10.1016/s0140-6736(78)91442-3. [DOI] [PubMed] [Google Scholar]
- McCaffrey R., Harrison T. A., Parkman R., Baltimore D. Terminal deoxynucleotidyl transferase activity in human leukemic cells and in normal human thymocytes. N Engl J Med. 1975 Apr 10;292(15):775–780. doi: 10.1056/NEJM197504102921504. [DOI] [PubMed] [Google Scholar]
- Miller D. R. Acute lymphoblastic leukemia. Pediatr Clin North Am. 1980 May;27(2):269–291. doi: 10.1016/s0031-3955(16)33851-2. [DOI] [PubMed] [Google Scholar]
- Pinkel D. Treatment of acute leukemia. Pediatr Clin North Am. 1976 Feb;23(1):117–130. doi: 10.1016/s0031-3955(16)33247-3. [DOI] [PubMed] [Google Scholar]
- Testicular disease in acute lymphoblastic leukaemia in childhood. Report on behalf of the Medical Research Council's Working Party on leukaemia in childhood. Br Med J. 1978 Feb 11;1(6109):334–338. doi: 10.1136/bmj.1.6109.334. [DOI] [PMC free article] [PubMed] [Google Scholar]